Abstract

Efficacy of Varenicline for Smoking Cessation between Smokers with and without Psychiatric Disorders: A 12-week Observational Study

Author(s): Han-Ting Wei, Wei-Chen Lin, Ying-Sheue Chen, Ying-Chiao Lee, Cheng-Ta Li, Kai-Lin Huang, Ya-Mei Bai

Background:

Patients with psychiatric disorders have high cigarette smoking-related morbidity and mortality. Varenicline, a α4β2 nicotinic acetylcholine receptor (nAChR) partial agonist, has been approved for smoking cessation, but few studies compared the efficacy between the smokers with and without different psychiatric disorders.

Methods:

Smokers aged more than 20 years with a daily cigarette consumption of more than 10 cigarettes/ or a Fagerstrom Test for Nicotine Dependence Scale (FTND) score of more than 4 were enrolled. The efficacy of smoking cessation and adverse effects were compared between the smokers with and without psychiatric disorders after 12-week varenicline treatment.

Results:

In total, 140 smokers were recruited, of whom 94 (67.1%) had psychiatric disorders, including schizophrenia (n=19), bipolar disorder (n= 29), depressive disorder (n=31), or other psychiatric disorders (n =15). Compared with the smokers without psychiatric disorders, those with psychiatric disorders were significantly more likely to be women, younger, have a shorter smoking history and a higher FTND score (all p<0.05). After 3 months of varenicline treatment, the smokers with psychiatric disorders had a significantly lower point smoking cessation rate (12.4% vs. 27.3%, p=0.012) and a lower percentage of daily reduced cigarette consumption (54% vs. 68%, p=0.02). The most commonly reported adverse events were nausea, without any group difference.

Conclusion:

The smokers with psychiatric disorders had a lower point smoking cessation rate than the smokers without psychiatric disorder after 12-week varenicline treatment. The development of novel tobacco treatments program integrated with psychiatric management for these patients is required.