From the Research
For smoking cessation, the most effective approach is to use varenicline, as it has been shown to be more effective than other pharmacotherapies, including bupropion and nicotine replacement therapy (NRT), according to a recent meta-analysis 1. The recommended approach is to use varenicline with proper instruction and support, as it has been shown to increase the chances of quitting smoking compared to placebo, with a risk ratio (RR) of 2.32 (95% CI 2.15 to 2.51) 1. While e-cigarettes containing nicotine may also be effective for smoking cessation, the current evidence is not as strong as that for varenicline, and more research is needed to fully understand their effectiveness and safety 1. Some key points to consider when using varenicline for smoking cessation include:
- Starting with a standard dose and gradually reducing it over time as dependence decreases
- Combining varenicline with behavioral support to increase success rates
- Being aware of potential side effects, such as nausea, headache, and insomnia, which are generally mild and temporary
- Monitoring for serious adverse events, such as cardiovascular and psychiatric events, although the evidence for these is limited and inconclusive 1. Overall, varenicline is a highly effective treatment for smoking cessation, and its use should be considered for all patients who are trying to quit smoking, especially those with chronic obstructive pulmonary disease (COPD), as smoking cessation is the most effective intervention in stopping the progression of COPD, as well as increasing survival and reducing morbidity 2.