• Posted May 3, 2024

Quit-Smoking Meds Not Working for You? Try Upping the Dose

Folks struggling to quit smoking might need a bump up on the dose of medication they’re using to help them stop, according to new clinical trial results.

Patients are more likely to successfully quit if the dose of their smoking cessation treatment is increased in response to an initial failure, researchers report in the Journal of the American Medical Association.

They also found that the drug varenicline (Chantix) is more effective than nicotine replacement therapy in helping smokers quit.

"These data indicate that sticking to the same medication isn't effective for smokers who are unable to quit in the first six weeks of treatment," lead researcher Paul Cinciripini said in a news release. He's chair of behavioral science at the University of Texas MD Anderson Cancer Center in Houston.

“Our study should encourage doctors to check in on patients early in their cessation journey and, if patients are struggling, to try a new approach, such as increasing medication dosage," he added.

Smokers taking varenicline who failed to quit in the clinical trial’s first phase were seven times more likely to quit by the end of the second phase if their dosage was increased, researchers found.

There also was a nearly twofold increase in success if smokers switched from nicotine replacement therapy to varenicline, results show.

Varenicline works similarly to the anti-opioid medication buprenorphine, by partially blocking the brain receptors that respond to nicotine. It’s taken in pill form.

For this trial, researchers randomly assigned 490 smokers to receive six weeks of either varenicline or nicotine replacement therapy.

After the first phase, those unable to quit were randomly told to either continue what they were doing, switch to the other therapy, or increase their medication dose.

About 20% of patients who received varenicline and had their dosage increased still weren’t smoking six weeks later.

At the same time, about 14% of patients were able to quit if they switched to varenicline from nicotine replacement or had their dose of nicotine replacement therapy increased.

However, not a single varenicline patient who switched to nicotine replacement wound up able to quit smoking, results show.

After six months, only the smokers who had their doses increased remained completely tobacco-free, researchers found.

Each year, about 480,000 Americans die from tobacco-related illnesses, and more than 16 million have at least one disease caused by smoking, researchers said in background notes.

A larger ongoing clinical trial now is testing several different medication combinations as alternatives for smokers who couldn’t quit using either varenicline or nicotine replacement, researchers said.

More information

The National Institutes of Health has more about varenicline.

SOURCE: University of Texas MD Anderson Cancer Center, news release, May 2, 2024