title: Use of stop-smoking medications in the United States before and after the introduction of varenicline.
abstract: OBJECTIVE
  To evaluate trends in use of stop-smoking medications (SSMs) before and after varenicline (Chantix™) was introduced to the market-place in the United States, and to determine whether varenicline reached segments of the population unlikely to use other SSMs.
  
  
  METHODS
  Cohort survey.
  
  
  METHODS
  United States.
  
  
  METHODS
  A nationally representative sample of adult smokers in the United States interviewed as part of the International Tobacco Control Four Country Survey between 2004 and 2011. Primary analyses used cross-sectional data from 1737 smokers who attempted to quit (∼450 per wave).
  
  
  METHODS
  Reporting an attempt to quit smoking; use of each of the following types of SSMs for the purpose of quitting smoking: nicotine gum, nicotine patch, other nicotine replacement therapy, bupropion and varenicline.
  
  
  RESULTS
  There was a significant increase in the rate of use of any SSM among quit attempters across the study period [odds ratio (OR) = 1.15, 95% confidence interval (CI) = 1.10-1.21 per year]. This increase was largest after varenicline was introduced (OR = 1.16, 95% CI = 1.07-1.26 per year); however, there was a decline in nicotine patch use during this time (OR = 0.87, 95% CI = 0.76-0.99 per year). Varenicline users were generally similar to users of other SSMs but differed from those who did not use any SSMs, in that they tended to be older (OR = 5.46, P = 0.024), to be white (OR = 2.33, P = 0.002), to have high incomes (OR = 1.85, P = 0.005), to have high nicotine dependence prior to quitting (OR = 2.40, P = 0.001) and to have used medication in the past (OR = 3.29, P < 0.001).
  
  
  CONCLUSIONS
  The introduction of varenicline in the United States coincided with a net increase in attempts to quit smoking and, among these, a net increase in use of stop-smoking medications. The demographic profile of varenicline users is similar to the profile of those who use other stop-smoking medications and different from the profile of those who attempt to quit without any medication.
authors.affiliation: Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY, USA.
authors.forename: Karin A
authors.initials: KA
authors.lastname: Kasza
authors.forename: K Michael
authors.initials: KM
authors.lastname: Cummings
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carpenter
authors.forename: Monica E
authors.initials: ME
authors.lastname: Cornelius
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Hyland
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Fong
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D003430:Cross-Sectional Studies; D017277:Drug Approval; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D061485:Tobacco Use Cessation Devices / Q000639:trends*; D014481:United States; D000068580:Varenicline / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D018722:Nicotinic Agonists; D000068580:Varenicline
keywords: Bupropion; cessation; nicotine replacement therapy; stop-smoking medication; trends; varenicline