title: Efficacy of varenicline to prompt quit attempts in smokers not currently trying to quit: a randomized placebo-controlled trial.
abstract: BACKGROUND
  Nicotine replacement therapy to aid smoking reduction increases the probability of a future quit attempt among smokers not currently planning to quit smoking. We tested whether varenicline, a partial nicotine agonist, would also increase future quit attempts.
  
  
  METHODS
  This randomized, placebo-controlled trial recruited 218 smokers who were interested in quitting but had no plans to quit in the next month. Participants used varenicline (2 mg/day) or placebo for 2-8 weeks plus received brief counseling on methods to reduce cigarettes/day. The primary measure was the incidence of a quit attempt within 6 months of study entry. Secondary measures were point prevalence abstinence, motivation to stop smoking, and reduction in cigarettes/day.
  
  
  RESULTS
  Varenicline increased the incidence of a quit attempt more than placebo at the Nebraska site (73% vs. 41%; p < .001) but not at the Vermont site (45% vs. 51%; p = .45). Varenicline increased most other measures of quit attempts, motivation and abstinence, independent of site. The beneficial effects of varenicline in quit attempts appeared to be mediated by greater reductions in cigarettes/day, dependence, craving, and cigarette satisfaction. Varenicline had a greater effect on quit attempts in less-dependent smokers, in minority smokers, and in those who had less prior cessation or reduction activity. Adverse events were minimal.
  
  
  CONCLUSIONS
  Varenicline increased quit attempts in smokers who are not currently trying to quit at one of the two study sites and improved most all secondary outcomes independent of site. This appeared to be due to decreasing cigarettes/day and level of dependence.
authors.affiliation: Department of Psychiatry and Psychology, University of Vermont, Burlington, VT 05401, USA. john.hughes@uvm.edu
authors.forename: John R
authors.initials: JR
authors.lastname: Hughes
authors.forename: Stephen I
authors.initials: SI
authors.lastname: Rennard
authors.forename: James R
authors.initials: JR
authors.lastname: Fingar
authors.forename: Sandy K
authors.initials: SK
authors.lastname: Talbot
authors.forename: Peter W
authors.initials: PW
authors.lastname: Callas
authors.forename: Karl O
authors.initials: KO
authors.lastname: Fagerstrom
mesh_terms: D000328:Adult; D001552:Benzazepines / Q000008:administration & dosage / Q000627:therapeutic use*; D037001:Directive Counseling; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009329:Nebraska / Q000453:epidemiology; D018722:Nicotinic Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D010865:Pilot Projects; D011810:Quinoxalines / Q000008:administration & dosage / Q000627:therapeutic use*; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention; D020340:Tobacco Use Cessation / Q000379:methods*; D061485:Tobacco Use Cessation Devices; D016896:Treatment Outcome; D000068580:Varenicline; D014707:Vermont / Q000453:epidemiology
chemical_list: D001552:Benzazepines; D018722:Nicotinic Agonists; D011810:Quinoxalines; D000068580:Varenicline