It is estimated that 14.5% of Australian adults are daily smokers. For many of these people, the New Year may be an opportune time to attempt to break the habit. However, this is often a difficult process and a number of attempts may be required before long-term abstinence is achieved.

A recent prospective cohort study sheds some light on how pharmacotherapy can be utilised to improve the success of a quit attempt following relapse. Smokers who changed the smoking cessation medication used were found to be more than twice as likely to achieve abstinence compared to smokers who used the same medication on subsequent attempts.

Bupropion, varenicline, and nicotine replacement therapy (NRT) are registered by the Therapeutic Goods Administration (TGA) for smoking cessation. A meta-analysis comparing the efficacy of these agents suggests that varenicline is superior to bupropion and NRT. However, combining a nicotine patch with a faster acting form of nicotine may provide similar efficacy to varenicline. It is also well documented that counselling and support are important factors in the quitting attempt.

Smoking cessation interventions are a valuable health promotion initiative. With an estimated 70% of smokers wanting to stop, advice and support is likely to deliver significant health benefits to this population. The choice of medication used in a quitting attempt should be based on patient preference, clinical suitability, and individual patient factors.

References:

  1. Cahill K, Stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev. 2013; CD009329.
  2. Psychotropic Expert Group. Smoking Cessation. In: eTG Complete. Melbourne: Therapeutic Guidelines; 2017.
  3. Heckman BW, Cummings M, Kasza KA, Borland R, Burris JL, Fong GT, et al. Effectiveness of switching smoking-cessation medications following relapse. Am J Prevent Med. 2017; 53(2): e63-e70.
  4. Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, et al. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2012; CD000146.

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