RESEARCH PAPER
A comparison of the efficacy of varenicline and bupropion and an evaluation of the effect of the medications in the context of the smoking cessation programme
 
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1
Department of Family Medicine, Karabuk University, Medical Faculty, Karabuk, Turkey
 
2
Altinyayla State Hospital, Altinyayla, Sivas, Turkey
 
3
Etimesgut State Hospital, Etimesgut, Ankara, Turkey
 
4
Cekerek Primary Care Unit, Cekerek, Turkey
 
5
Department of Family Medicine, Cumhuriyet University, Medical Faculty, Sivas, Turkey
 
 
Submission date: 2016-02-21
 
 
Acceptance date: 2017-01-21
 
 
Publication date: 2017-02-01
 
 
Corresponding author
Ali Ramazan Benli   

Department of Family Medicine, Karabuk University, Medical Faculty, 78000 Karabuk, Turkey
 
 
Tob. Induc. Dis. 2017;15(February):10
 
KEYWORDS
ABSTRACT
Background:
Within the context of the support program for smoking cessation, initiated by the Turkish Ministry of Health in 2011, those who present at ‘smoking cessation’ centres and are found to be suitable for pharmacological treatment are given varenicline and bupropion free of charge. As the smoking cessation programme is centralized, the selection of the medication is made randomly to provide a fixed distribution rate. The aim of this study was to evaluate the efficacy of both varenicline and bupropion in smoking cessation and to evaluate the effect of the smoking cessation programme.

Methods:
A total of 405 individuals who met the study criteria were included in the study. Smoking habits and degree of dependence were determined in all the participants with the Fagerstrom test for nicotine dependence (FTND) and bupropion or varenicline therapy was initiated in those who were eligible. Patients were followed up at 15 days then at 1, 2, 3, 6 and 12 months after smoking cessation. A level of CO < 5 ppm and ‘point prevalence abstinence’ were used as the criteria of success for smoking cessation and this evaluation showed the non-smoking status in the previous 7 days.

Results:
The mean age of the participants was 35.19 ± 7.73 years and 82.8% (n = 334) were male. Of the participants, 60.2% (n = 244) were given varenicline and 39.8% (n = 161) bupropion. The mean FTND and package/year was not significantly different between the groups. The rates of success in the 1st and 2nd weeks, and 1st, 3rd and 6th months were significantly higher in the varenicline group than in the bupropion group (p < 0.05). At the end of one year, the rate of smoking cessation was determined as 13.9% (n = 34) in the varenicline group and 6.2% (n = 10) in the bupropion gruop. The difference was statistically significant (p = 0.015). At the end of 1 year when the previous 7 days smoking status was evaluated with the ‘point prevalence abstinence’ measurement as the success criteria, success rates were 20.5% with varenicline and 18.6% with bupropion and the difference was not significant (p = 0.646). The individuals who used the medications for 45 days or longer were more successful in smoking cessation (p < 0.001). The most common reasons given for discontinuing the medication were the side-effects (31.5%). No significant difference was determined between the groups in respect of the side-effects observed.

Conclusions:
Although the rates of smoking cessation in all the other control points were higher with varenicline than with bupropion, no significant difference was found between the success rates of varenicline and bupropion used in smoking cessation based on the last 7 days at the end of one year. Those who used the medications for 45 days or longer were more successful in smoking cessation.

 
REFERENCES (32)
1.
O’Brien CP, Gardner EL. Critical assessment of how to study addiction and its treatment: human and non-human animal models. Pharmacol Ther. 2005;108(1):18–58. doi:10.1016/j.pharmthera.2005.06.018.
 
2.
Hecht SS. Tobacco smoke carcinogens and lung cancer. J Natl Cancer Inst. 1999;91(14):1194–210. doi:10.1093/jnci/91.14.1194.
 
3.
Bektas M, Ozturk C, Armstrong M. An approach to children’s smoking behaviors using social cognitive learning theory. Asian Pac J Cancer Prev. 2010;11(4):1143–9.
 
4.
Yengil E. Smoking among medical school students and attitudes against smoking. Konuralp Tıp Dergisi (in Turkish). 2014;2014(3):1–7. Available from: http://dergipark.ulakbim.gov.t....
 
5.
Elbek O, Kılınç O, Aytemur ZA, Akyıldız L, Küçük ÇU, Özge C, et al. Tobacco control in Turkey. Turk Thorac J. 2015;16:141–50. doi:10.5152/ttd.2014.3898.
 
6.
Uysal MA, Kadakal F, Karsidag C, Bayram NG, Uysal O, Yilmaz V. Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis. Tuberk Toraks. 2004;52(2):115–21.
 
7.
Perkins KA, Karelitz JL, Jao NC. Optimal carbon monoxide criteria to confirm 24-hr smoking abstinence. Nicotin Tob Res. 2013;15(5):978–82. doi:10.1093/ntr/nts205.
 
8.
Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz N, Curry SJ et al. Treating Tobacco Use and Dependence: 2008 Update, Clinical Practice Guideline. Hartford CT U.S. Department of Health and Human Services, Public Health Service; 2009. https://books.google.com.tr/bo....
 
9.
Keely JP, Hughes JR, Carpenter MJ. A method to convert prolonged abstinence and point prevalence quit rates. Nicotin Tob Res. 2001;3:272–3.
 
10.
Cahill K, Stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2013;5:CD009329. doi: 10.1002/14651858.CD009329.pub. http://onlinelibrary.wiley.com....
 
11.
Wu L, Sun S, He Y, Zeng J. Effect of smoking reduction therapy on smoking cessation for smokers without an intention to quit: an updated systematic review and meta-analysis of randomized controlled trials Int. J Environ Res Public Health. 2015;12:10235–53. doi:10.3390/ijerph120910235.
 
12.
Hughes JR, Stead LF, Hartmann BJ, et al. Antidepressants for smoking cessation. Cochrane Database Syst Rev. 2014;8(1):CD000031. doi: 10.1002/14651858.CD000031.pub4.
 
13.
Ottawa (ON). Nicotine Replacement Therapy, Bupropion and Varenicline for Tobacco Cessation: A Review of Clinical Effectiveness. Canadian Agency for Drugs and Technologies in Health. 2016 Mar 08.PMID: 27077161.
 
14.
Sağlam L. Investigation of the results of a smoking cessation clinic and the factors associated with success. Turk J Med Sci. 2012;42:515–22. doi:10.3906/sag-1101-1452.
 
15.
Hagimoto A, Nakamura M, Morita T, Masui S, Oshima A. Smoking cessation patterns and predictors of quitting smoking among the Japanese general population: a 1‐year follow‐up study. Addiction. 2010;105(1):164–73. doi:10.1111/j.1360-0443.2009.02735.x.
 
16.
Salepçi B, Fidan A, Oruc O, Torun E, Çağlayan B, Kader ŞN. Success rates in our smoking cessation clinic and factors affecting it. Turkish Thoracic J. 2005;6:151–8.
 
17.
Kökten R. Trakya Üniversitesi Tıp Fakültesi Sigara Bırakma Polikliniği çalışmalarının değerlendirilmesi. 2008. Available from: http://193.255.140.91:8080/jsp....
 
18.
Jorenby DE, Hays JT, Rigotti NA, Azoulay S, Watsky EJ, Williams KE, et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA. 2006;296(1):56–63. doi:10.1001/jama.296.1.56.
 
19.
Fidan F, Ebru P, Mehmet Ü, Sezer M, Ziya K. Factors Affecting Smoking Cessation and Success Rates of The Treatment Methods Used. Kocatepe Tıp Dergisi (in Turkish). 2005;6(3):27-34. Available from: http://www.kocatepetipdergisi.....
 
20.
Rigotti NA, Pipe AL, Benowitz NL, Arteaga C, Garza D, Tonstad S. Efficacy and safety of varenicline for smoking cessation in patients with cardiovascular disease a randomized trial. Circulation. 2010;121(2):221–9. doi:10.1161/CIRCULATIONAHA.109.869008.
 
21.
Gonzales D, Rennard SI, Nides M, Oncken C, Azoulay S, Billing CB, et al. Varenicline, an α4β2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA. 2006;296(1):47–55. doi:10.1001/jama.296.1.47.
 
22.
Lee J-Y, Kim MJ, Jun H-J, Kang M, Park AR, Oh DE, et al. Adherence to varenicline and abstinence rates for quitting smoking in a private health promotion center-based smoking cessation clinic. Tuberc Respir Dis (Seoul). 2012;72(5):426–32. doi:10.4046/trd.2012.72.5.426.
 
23.
Sheffer CE, Stitzer M, Landes R, Brackman SL, Munn T, Moore P. Socioeconomic disparities in community-based treatment of tobacco dependence. Am J Public Health. 2012;102(3):8–16. doi:10.2105/AJPH.2011.300519.
 
24.
Pan W. Proactive telephone counseling as an adjunct to minimal intervention for smoking cessation: a meta-analysis. Health Educ Res. 2006;21(3):416–27. doi:10.1093/her/cyl040.
 
25.
Stapleton J, West R, Hajek P, Wheeler J, Vangeli E, Abdi Z, et al. Randomized trial of nicotine replacement therapy (NRT), bupropion and NRT plus bupropion for smoking cessation: effectiveness in clinical practice. Addiction. 2013;108(12):2193–201. doi:10.1111/add.12304.
 
26.
Rose JE, Behm FM, Westman EC. Nicotine–mecamylamine treatment for smoking cessation: the role of pre-cessation therapy. Exp Clin Psychopharmacol. 1998;6(3):331–43. doi:10.1037/1064-1297.6.3.331.
 
27.
Dollar KM, Homish GG, Kozlowski LT, Leonard KE. Spousal and alcohol-related predictors of smoking cessation: a longitudinal study in a community sample of married couples. Am J Public Health. 2009;99(2):231–3. doi:10.2105/AJPH.2008.140459.
 
28.
Li L, Borland R, Yong H-H, Fong GT, Bansal-Travers M, Quah AC, et al. Predictors of smoking cessation among adult smokers in Malaysia and Thailand: findings from the International Tobacco Control Southeast Asia Survey. Nicotin Tob Res. 2010;12(1):34–44. doi:10.1093/ntr/ntq030.
 
29.
Prochaska JO, DiClemente CC, Velicer WF, Ginpil S, Norcross JC. Predicting change in smoking status for self-changers. Addict Behav. 1985;10(4):395–406. doi:10.1016/0306-4603(85)90036-X.
 
30.
Hymowitz N, Cummings KM, Hyland A, Lynn WR, Pechacek TF, Hartwell TD. Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tob Control. 1997;6(2):57–62. doi:10.1136/tc.6.suppl_2.S57.
 
31.
Peterson Jr AV, Kealey KA, Mann SL, Marek PM, Ludman EJ, Liu J, Bricker JB. Group-randomized trial of a proactive, personalized telephone counseling 112 intervention for adolescent smoking cessation. J Natl Cancer Inst. 2009;101(20):1378–92.
 
32.
Stead LF, Perera1 R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2006:CD002850. DOI: 10.1002/14651858.CD002850.pub2 Available from: http://onlinelibrary.wiley.com....
 
 
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8.
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9.
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10.
The Maudsley Prescribing Guidelines in Psychiatry
 
11.
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Esra ERSOY, Huseyin CETİN, Sabah TUZUN, Can ÖNER, Sevda CÖMERT, Engin ŞİMŞEK
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12.
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13.
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Kangle Guo, Liying Zhou, Xue Shang, Chaoqun Yang, Fenfen E, Yan Wang, Meng Xu, Yanan Wu, Yanfei Li, Meixuan Li, Kehu Yang, Xiuxia Li
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14.
Nicotine receptor partial agonists for smoking cessation
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Cochrane Database of Systematic Reviews
 
15.
Nicotine receptor partial agonists for smoking cessation
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16.
Antidepressants for smoking cessation
Anisa Hajizadeh, Seth Howes, Annika Theodoulou, Elias Klemperer, Jamie Hartmann-Boyce, Jonathan Livingstone-Banks, Nicola Lindson
Cochrane Database of Systematic Reviews
 
17.
Varenicline but not cotinine increased the value of a visual stimulus reinforcer in rats: No evidence for synergy of the two compounds
Sydney D. Houser, Kathleen R. McNealy, Scott T. Barrett, Rick A. Bevins
Pharmacology Biochemistry and Behavior
 
18.
The efficacy and acceptability of pharmacological monotherapies and e-cigarette on smoking cessation: a systemic review and network meta-analysis
Yajing Meng, Sike Xiang, Lang Qu, Ying Li
Frontiers in Public Health
 
19.
Evaluation of (S)-T1 and (S)-T2 ligands targeting α3β4 nAChR as potential nicotine addiction pharmacotherapy
Saranda Nianpanich, Ratchanee Rodsiri, Ridho Islamie, Patanachai Limpikirati, Thanundorn Thanusuwannasak, Opa Vajragupta, Apinan Kanasuwan, Jiradanai Sarasamkan
Psychopharmacology
 
20.
Switching from Cigarettes to Heated Tobacco Products in Japan—Potential Impact on Health Outcomes and Associated Health Care Costs
Joerg Mahlich, Isao Kamae
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