The effect of varenicline and nicotine patch on smoking rate and satisfaction with smoking: an examination of the mechanism of action of two pre-quit pharmacotherapies.
OBJECTIVE
In recent years, there has been growing research interest in using nicotine replacement medications to aid smoking reduction prior to a quit attempt. Gaining a better understanding of how treatments influence smoking reduction may allow for better tailoring of treatments and, ultimately, better cessation outcomes. The objective of the current study was to test the effects of the pre-quit use of varenicline and nicotine patch on smoking rate and satisfaction with smoking.


METHODS
All participants were required to attend up to five study visit sections. Participants (n = 213) who were interested in quitting were randomised (open-label) to receive either pre-quit patch or varenicline (both treatments started 2 weeks prior to an assigned quit day, followed by 10 weeks post-quit) or standard patch (10 weeks starting from an assigned quit day). Participants used modified smartphones to monitor their smoking in real time for 4 weeks.


RESULTS
Participants in the two pre-quit treatment groups reported significant reductions in both their satisfaction with smoking (p < 0.001) and smoking rate (p < 0.001) from baseline to the end of pre-quit period; participants in the standard patch group did not. The observed reduction of smoking rate was associated with the satisfaction with smoking (p < 0.01), although the mediation effect of satisfaction was small.


CONCLUSIONS
Pre-quit treatment caused reductions in satisfaction with smoking and smoking rate. Satisfaction was associated with changes in smoking rate, but the relationship was weak. As such, monitoring reductions in satisfaction do not appear to be a viable method of evaluating responsiveness to treatment.
School of Medicine, University of Tasmania, Hobart, TAS, 7001, Australia.
Wenying
W
Lu
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
Kate
K
Chappell
School of Medicine, University of Tasmania, Hobart, TAS, 7001, Australia.
Julia A E
JAE
Walters
School of Medicine, University of Tasmania, Hobart, TAS, 7001, Australia.
Glenn A
GA
Jacobson
School of Medicine, University of Tasmania, Hobart, TAS, 7001, Australia.
Rahul
R
Patel
School of Health Science, University of Tasmania, Hobart, Australia.
Natalie
N
Schüz
School of Medicine, University of Tasmania, Private Bag 34, Hobart, TAS, 7001, Australia. stuart.ferguson@utas.edu.au.
Stuart G
SG
Ferguson
D006801:Humans; D009538:Nicotine / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D010549:Personal Satisfaction; D012107:Research Design; D000068997:Smartphone; D016540:Smoking Cessation / Q000379:methods*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*; D000073869:Tobacco Smoking / Q000188:drug therapy*; D061485:Tobacco Use Cessation Devices; D000068580:Varenicline / Q000493:pharmacokinetics / Q000494:pharmacology*
D018722:Nicotinic Agonists; D009538:Nicotine; D000068580:Varenicline
Nicotine patch; Nicotine replacement therapy; Satisfaction; Smoking cessation; Varenicline