Benefits of smoking cessation medications diminish over time

January 30, 2018, Tel Aviv University
Benefits of smoking cessation medications diminish over time
Credit: Tel Aviv University

A new Tel Aviv University study published in Addiction finds that only eight out of 100 smokers who take smoking cessation medications will have benefited from taking smoking medications after one year's time. The researchers conclude that this low rate of success should lead policymakers to find better methods to help smokers quit—and to prevent young people from taking up smoking to begin with.

Dr. Laura J. Rosen of the School of Public Health at TAU's Sackler Faculty of Medicine led the research, which was conducted in collaboration with Prof. Laurence S. Freedman of TAU's Sackler Faculty of Medicine and The Gertner Institute of Epidemiology and Health Policy Research; Dr. Tal Galili of TAU's Faculty of Exact Sciences; and Dr. Jeffrey Kott and Dr. Mark Goodman, who are graduates of TAU's Sackler School of Medicine.

Smoking cigarettes is the most common cause of preventable death in the world today. Although FDA-approved have proven effective in controlled experiments, to what extent these benefits persist over time had previously remained unclear.

"By the end of the first year of intervention, only eight out of 100 smokers will have abstained from smoking due to the smoking medication," Dr. Rosen says. "This study is particularly important in Israel, where 22.5% of adults smoke and the rate of smoking is not declining. While the Israeli national healthcare system offers a strong package of aid to smokers who want to quit, there is no permanent funding for other tobacco control strategies."

In the US, smoking has declined from 20.6% of the population in 2009 to 15.1% of the population in 2015.

The scientists used meta-analysis to combine the results of 61 randomized controlled trials involving some 28,000 participants who took the first-line FDA-approved smoking cessation medications bupropion (Zyban), nicotine replacement therapy (NRT) or varenicline (Chantix/Champix). In all of the trials, participants were randomized either to an intervention group, which received smoking cessation medications, or to a control group, which did not receive active medications. Most of the trials also featured some form of counseling in addition to the medication.

"Less than 40% of those receiving the medications continued to abstain from smoking after three months, about 25% had still quit after six months, and about only a fifth—20%—remained abstinent after a full year," Dr. Rosen says. "Importantly, 12 percent of those who did not receive active medication continued to abstain from smoking after one year. Because benefit is calculated by starting with the quit rate among those who received the medication, and subtracting from the percentage who quit in the groups which didn't receive the medication, just 8 percent of smokers who received cessation medications continued to benefit from the drugs after one year."

A wake-up call for policymakers and physicians

According to Dr. Rosen, this study differs from previous meta-analyses in that it examines the relative success of quitting over different time periods (3, 6, and 12 months) and the overall decline in benefits from the over time.

"This study is a wakeup call for policymakers everywhere and for physicians who treat smokers," Dr. Rosen concludes. "Much more needs to be done to reduce tobacco use and its enormous toll on the population. We applaud current efforts by the FDA to develop more beneficial forms of medicinal nicotine for who want to quit. Policymakers should to use all possible means to prevent young people from starting to smoke. Prevention of entry into the cycle of addiction is the best possible medicine."

Explore further: Helping smokers quit: Payments, personalized support can work

More information: Laura J. Rosen et al, Diminishing benefit of smoking cessation medications during the first year: a meta-analysis of randomized controlled trials, Addiction (2018). DOI: 10.1111/add.14134

Related Stories

Helping smokers quit: Payments, personalized support can work

October 30, 2017
Money can be more powerful than nicotine, as a new study found that smokers who received financial incentives, in addition to personalized support, to help them quit were more successful than smokers who did not receive these ...

Medications alone don't help smokers quit, study finds

December 21, 2017
Pharmaceutical interventions are routinely prescribed to help people quit smoking. However, a new study by University of California San Diego School of Medicine researchers suggests that, despite promising results in clinical ...

Study finds differing treatment options for women smokers

July 13, 2016
A new study led by Assistant Medical Professor Philip Smith of The City College of New York's Sophie Davis Biomedical Education/CUNY School of Medicine, and conducted in collaboration with researchers at Yale University and ...

Medicaid policies that help smokers quit also save on health care costs

October 27, 2016
Medicaid policies that require patients to go for tobacco-cessation counseling before they get a nicotine patch or some other type of anti-smoking drug actually lead to a reduction in the use of such medication, according ...

Managing negative emotions can help pregnant smokers quit

September 19, 2017
A new study by scientists in the University at Buffalo's Research Institute on Addictions has shown that pregnant smokers are more likely to quit if they can learn to manage negative emotions that lead to smoking.

Elderly heart attack survivors rarely filled prescription smoking cessation medications

November 14, 2016
Elderly smokers who were discharged from the hospital after having a heart attack rarely filled prescriptions for medications that might help them quit smoking, despite being counseled about the need to quit during their ...

Recommended for you

College students choose smartphones over food

November 16, 2018
University at Buffalo researchers have found that college students prefer food deprivation over smartphone deprivation, according to results from a paper in Addictive Behaviors.

Drug overdose epidemic goes far beyond opioids, requires new policies

November 7, 2018
Most government-funded initiatives to address the overdose epidemic in the United States have targeted opioids specifically and have neglected other drugs that are increasingly implicated in overdoses, such as cocaine and ...

Cocaine adulterant may cause brain damage

November 1, 2018
People who regularly take cocaine cut with the animal anti-worming agent levamisole demonstrate impaired cognitive performance and a thinned prefrontal cortex. These findings from two recent studies at the University of Zurich ...

Poverty blamed on widening north-south gap in young adult deaths in England

November 1, 2018
A major study of mortality across England led by University of Manchester data scientists blames socioeconomic deprivation for sharp rises in deaths among 22 to 44-year-olds living in the North of England.

Prenatal exposure to substances found in plastics associated with language development delays

October 30, 2018
Pregnant mothers' exposure to phthalates – substances often used in personal care products, children's toys and more – may be linked to delays in language development during early childhood, according to a study published ...

Dopamine drives early addiction to heroin

October 30, 2018
Scientists have made a major advance in untangling the brain circuits that lead to the powerful addictive effects of heroin, a study in the open-access journal eLife reports.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.