Study identifies smokers most likely to benefit from combination treatments

Newly published research suggests that combination treatments for smoking cessation can assist individuals who were not helped by one treatment alone, and that men and highly nicotine-dependent smokers tend to benefit most from the combination therapies.

Published online today in the American Journal of Psychiatry, the findings were derived from a study of nearly 350 adults who smoked more than 10 cigarettes a day. All subjects received a nicotine patch for a week, and those who were not able to reduce their smoking by 50% then received varenicline and a placebo or varenicline and bupropion for 12 weeks. The group receiving varenicline and bupropion had the best outcomes, with just under 40% abstaining from smoking at weeks 8 to 11 after their target quit date.

“It's clear that we need to improve success rates for smoking cessation, and it is thought that combining treatments could add to the efficacy,” said Jed Rose, PhD, director of the Duke Center for Smoking Cessation and the study's lead author. “Combining two therapies, especially if they act by different mechanisms, may address different aspects of the addiction.”

Female smokers and those with relatively low levels of nicotine dependence derived little benefit from the combination treatment of varenicline and bupropion. This suggested to researchers that while giving all patients a combination of medications might prove to be overly expensive, they might have identified the patient groups for which this strategy could be targeted in order to ensure optimal success.

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