Smoking cessation outcomes over the long term generally have been poor for individuals with serious mental illness, but a newly published study indicates that the medication varenicline can promote long-term abstinence when added to conventional therapy for these patients.
The study, published online Jan. 8 in the Journal of the American Medical Association, examined 87 smokers with schizophrenia or bipolar disorder who had achieved abstinence from smoking after 12 weeks of open-label treatment with varenicline (sold under the brand name Chantix) and cognitive-behavioral therapy (CBT). These smokers were then randomized to CBT and varenicline (1 mg twice daily) or placebo for an additional 40 weeks, to reach a total duration of one year of treatment.
Sixty-one of the 87 individuals completed the second phase of treatment. Counting both treatment completers and non-completers (the non-completers were categorized as having relapsed), the researchers found that point-prevalence abstinence rates were 60% in the varenicline group and 19% in the placebo group. Looking out an additional 24 weeks after treatment ended, the researchers found that rates of continuous abstinence from weeks 12 through 76 were 30% in the varenicline group and 11% in the placebo group.
The National Institute on Drug Abuse (NIDA) stated in a communication about the research, “The results of this study suggest that it is feasible to prescribe varenicline to these patients, which could lessen the health burdens caused by smoking in this population.”