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Combining treatments boosts some smokers' ability to quit
Date:6/16/2014

they act by different mechanisms, may address different aspects of the addiction."

To measure the benefit of combining treatments, the researchers enrolled 349 adults who reported smoking 10 or more cigarettes a day. A six-item questionnaire measured the smokers' level of nicotine dependence. All participants were given nicotine patches prior to quitting.

After a week on the nicotine patch, the 222 participants who did not cut their smoking by 50 percent while on the patch were randomly assigned to take either varenicline and a placebo or a combination of varenicline and bupropion.

The participants took the assigned treatments for 12 weeks, and were followed periodically for six months. The varenicline and bupropion were generally well tolerated, with side effects including headache, dry mouth, irritability, insomnia, vivid dreams and changes in taste.

The researchers observed an overall benefit of adding bupropion to varenicline, with 39.8 percent of participants on the combination treatment abstaining from smoking at weeks 8-11 after the target quit date, versus 25.9 percent taking varenicline alone.

The combined treatment had a much greater effect on male smokers and those highly dependent on nicotine, while no significant difference was seen in female smokers or those with lower levels of nicotine dependence.

Smokers who were both male and highly dependent saw the greatest benefit of the combination of treatments.

"Highly dependent male smokers had a boost in quit rates from 14 percent on varenicline alone to 61 percent with the combination treatment, which is a dramatic increase," Rose said.

"While there may be some drawbacks to prescribing two smoking cessation treatments, such as cost or possible side effects, this study gives us a simple strategy to find those who would benefit the most from combined treatment, and spare others who may not benefit."

The researchers said add
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Contact: Rachel Harrison
rachel.harrison@duke.edu
919-419-5069
Duke University Medical Center
Source:Eurekalert

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