Medications greatly improve smokers' chances of quitting, study finds

Stop-smoking medications such as nicotine replacement therapy (NRT), bupropion and varenicline have been shown to be effective in clinical trials, but population-based studies have produced mixed results on effectiveness when medications are used outside the confines of a research study. This latest study, conducted through the International Tobacco Control (ITC) research collaboration, is one of the largest real-world evaluations of medication effectiveness conducted to date, and the first to comprehensively control for biases in participants’ recall of quit attempts.

The study tracked the smoking behaviors of more than 2,500 adult smokers in the United Kingdom, Canada, Australia and the United States who reported making a quit attempt between 2006 and 2009. Study participants were asked how recently they had attempted to quit and whether they used any type of stop-smoking medication. Six-month continuous abstinence among those who recalled making a very recent quit attempt was assessed at the next follow-up interview. The results showed that those who used varenicline, bupropion or the nicotine patch had much higher quit success at six months compared to those who tried to quit without using medication.

“By restricting our analyses to those who made very recent quit attempts, we reduced the extent to which differences in quit-attempt recall could bias the estimates of medication effectiveness. Consistent with the strong evidence from clinical trials, our findings show that medications are indeed effective in increasing smokers’ chances of quitting when used in the real world,” said Karin Kasza, MA, statistician in the Division of Cancer Prevention & Population Sciences at RPCI and lead author of the study.

Ron Borland, PhD, Nigel Gray Distinguished Fellow in Cancer Prevention at the Cancer Council Victoria in Melbourne, Australia and a co-author of the study, added, “The major advance of this study is that we have been able to show that greater forgetting of unassisted failed attempts is the most likely reason other studies have not found a benefit for medication in population-based settings. This finding should reassure clinicians and public health workers to continue to encourage the widespread use of medications.”

“Despite the benefit of using medications, many smokers still try to quit without help. And even when medications are used, quitting smoking is hard, and relapses are common. Continued efforts are needed to develop and deliver more effective treatments to help smokers who want to quit,” said Andrew Hyland, PhD, Chair of the Department of Health Behavior at RPCI.

The ITC Policy Evaluation Project (www.itcproject.org) is a collaborative effort with international health organizations and policymakers in more than 20 countries inhabited by more than 50% of the world’s population, 60% of the world’s smokers, and 70% of the world’s tobacco users. In each country, the ITC Project is conducting prospective cohort surveys to assess the impact and identify the determinants of effective tobacco control policies.

More information: The study, “Effectiveness of Stop-Smoking Medications: Findings from the International Tobacco Control (ITC) Four Country Survey,” can be accessed at onlinelibrary.wile… 9.x/abstract

Provided by Roswell Park Cancer Institute