Smokers who took the pill, sold as
Chantix in the US and Champix elsewhere, were much more likely to quit after
cutting back on cigarettes than smokers who did not use the drug, the study
found.
"This allows us to reach a much broader population of smokers who
aren't willing to quit abruptly or set a quit date, and it shows that people can
quit without going cold turkey," said lead study author Dr Jon Ebbert, a
professor in primary care and internal medicine at the Mayo Clinic in Rochester,
Minnesota. "This is very strong support for changing clinical practice to
include gradual reduction aided by medication."
Smoking is the leading
cause of preventable death in the US, according to the Centres for Disease
Control and Prevention. And tobacco kills one in 10 people worldwide, according
to the World Health Organization.
Quitting can reduce the risk of heart
attacks, strokes, and cancers of the mouth, throat, esophagus and bladder. Ten
years after quitting, the risk of lung cancer drops by half, according to the
CDC.
To see if Chantix, which is manufactured by Pfizer, could help
smokers quit without going cold turkey, Ebbert and colleagues randomly assigned
1,510 people at 61 centres in 10 countries to receive either the drug or a
placebo for 24 weeks.
They asked study participants to reduce cigarette
use by 50 percent by the fourth week, and by 75 percent by the eight week, with
the goal of quitting by week 12.
By the last ten weeks of treatment,
weeks 15 to 24, the group taking the pill had significantly higher abstinence
rates than the group on placebo.
This held true even after treatment
stopped. For weeks 21 through 52 of the study, 27 percent of the people who had
previously taken the drug successfully avoided smoking, compared with less than
10 percent of those who received the placebo.
“This is the first study of
its kind to enroll a group of smokers who are not traditionally enrolled in
clinical trials because they are not ready to quit,” said Dr. Caryn Lerman,
professor of psychiatry and deputy director of the Abramson Cancer Centre at the
University of Pennsylvania in Philadelphia.
“It offers compelling
evidence that gradual reduction should be considered to facilitate quitting,”
she said.
But even though the approach helped some hard-to-reach smokers,
the majority of them still failed to quit, noted Lerman, who wasn’t involved in
the study. Other treatments, such as nicotine patches and gum, can also help
some smokers cut back gradually, she said.
While the study shows that
Chantix, which is known generically as varenicline, can be effective for some
smokers, the group taking the pill also experienced more side effects such as
nausea, abnormal dreams, insomnia, constipation, vomiting, and weight
gain.
Previous research has linked Chantix to side effects including
suicidal thoughts, erratic behavior and drowsiness. The U.S. Food and Drug
Administration placed a black box warning - its most severe and restrictive
warning - on the product in 2009, highlighting the drug's adverse
neuropsychological effects.
People with a history of major depressive or
anxiety disorder, suicidal behavior, panic disorder, post-traumatic stress
disorder, schizophrenia, or psychosis were excluded from the study, published in
the American Medical Association’s journal JAMA. abd71
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