Varenicline for smokeless tobacco cessation

January 01, 0001

Varenicline for smokeless tobacco cessation

Varencicline is used to help patients quit smoking cigarettes. These Swedish, UK, and US researchers examined efficacy and safety of varenicline for smokeless tobacco cessation. They performed a double blind, placebo controlled, parallel group, multicentre, randomized controlled trial based in Norway and Sweden. Enrollees were over the age of 18 who used smokeless tobacco mutliple times a day (n=431). They were randomized to varenicline 1 mg twice daily or placebo for 12 weeks. Abstinence was confirmed with cotinine measurement.

The researchers found: "Continuous abstinence rate at week 9-12 was higher in the varenicline group than the placebo group (59% {125} v 39% {85}, relative risk 1.60, number needed to treat 5). The advantage of varenicline over placebo persisted through 14 weeks of follow-up (continuous abstinence rate at week 9-26 was 45% (95) v 34% (73), relative risk 1.42, number needed to treat 9). The most common adverse events in the varenicline group compared with the placebo group were nausea (35% {74} v 6% {14}), fatigue (10% {22} v 7% {15}), headache (10% {22} v 9% {20}), and sleep disorder (10% {22} v 7% {15}). Few adverse events led to discontinuation of treatment (9% {19} and 4% {9}, respectively), and serious adverse events occurred in two (1%) and three (1%) participants, respectively."

The researchers concluded: "Varenicline can help people to give up smokeless tobacco and has an acceptable safety profile. The response rate in the placebo group in this study was high, suggesting a population less resistant to treatment than smokers."

This pharmaceutical company sponsored study finds that varencicline may also be beneficial in helping patients quit smokeless tobacco.

For the full abstract, click here.

BMJ 341:c6549, 6 December 2010 © 2010 BMJ Publishing Group Ltd.
Stopping smokeless tobacco with varenicline: randomised double blind placebo controlled trial. Karl Fagerström, Hans Gilljam, Michael Metcalfe, Serena Tonstad, Michael Messig. Correspondence to K Fagerström: [email protected]

Category: A. General/Unspecified. Keywords: varencicline, smokeless tobacco, cessation, tolerability, safety, randomized controlled trial, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 17 December 2010 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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