title: Effects of varenicline on abstinence and smoking reward following a programmed lapse.
abstract: BACKGROUND
  Varenicline (Chantix®) is an efficacious first-line medication for smoking cessation. Studies suggest that one mechanism by which varenicline facilitates sustained smoking abstinence is by reducing the likelihood of relapse to smoking when a lapse, or slip, occurs during a quit attempt. The present study extends this line of research by conducting a prospective laboratory study to examine the relapse prevention effects of varenicline following a programmed lapse.
  
  
  METHODS
  Daily smokers (N = 47) completed a 5-week outpatient study in which they were randomized to receive varenicline or placebo. The first week was a medication induction period that was immediately followed by a 4-week quit attempt. A programmed lapse (2 cigarettes smoked in the laboratory) occurred on the second day of the quit attempt.
  
  
  RESULTS
  Participants receiving varenicline were slower to relapse and had greater total abstinence rates following lapse exposure. Participants in the varenicline group rated lapse cigarettes lower on measures of reward and intoxication and showed increased behavioral economic demand elasticity for cigarettes (reduced cigarette purchasing at higher prices) compared with those receiving placebo.
  
  
  CONCLUSIONS
  These results demonstrate a relapse prevention effect of varenicline following smoking lapse exposure and suggest that an attenuation of reward from smoking and the blunting of subjective effects of smoking may underlie and/or contribute to this effect.
authors.affiliation: Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. emcclur4@jhmi.edu
authors.forename: Erin A
authors.initials: EA
authors.lastname: McClure
authors.forename: Ryan G
authors.initials: RG
authors.lastname: Vandrey
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Johnson
authors.forename: Maxine L
authors.initials: ML
authors.lastname: Stitzer
mesh_terms: D000328:Adult; D001552:Benzazepines / Q000627:therapeutic use*; D003367:Cotinine / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D011810:Quinoxalines / Q000627:therapeutic use*; D012201:Reward; D055502:Secondary Prevention; D012907:Smoking / Q000188:drug therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology*; D000074606:Smoking Prevention; D016896:Treatment Outcome; D000068580:Varenicline
chemical_list: D001552:Benzazepines; D011810:Quinoxalines; D003367:Cotinine; D000068580:Varenicline