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Efficacy of Varenicline for Smoking Cessation between Smokers with and without Psychiatric Disorders: A 12-week Observational Study

Author(s): Han-Ting Wei, Wei-Chen Lin, Ying-Sheue Chen, Ying-Chiao Lee, Cheng-Ta Li, Kai-Lin Huang, Ya-Mei Bai


Patients with psychiatric disorders have high cigarette smoking-related morbidity and mortality. Varenicline, a α4β2 nicotinic acetylcholine receptor (nAChR) partial agonist, has been approved for smoking cessation, but few studies compared the efficacy between the smokers with and without different psychiatric disorders.


Smokers aged more than 20 years with a daily cigarette consumption of more than 10 cigarettes/ or a Fagerstrom Test for Nicotine Dependence Scale (FTND) score of more than 4 were enrolled. The efficacy of smoking cessation and adverse effects were compared between the smokers with and without psychiatric disorders after 12-week varenicline treatment.


In total, 140 smokers were recruited, of whom 94 (67.1%) had psychiatric disorders, including schizophrenia (n=19), bipolar disorder (n= 29), depressive disorder (n=31), or other psychiatric disorders (n =15). Compared with the smokers without psychiatric disorders, those with psychiatric disorders were significantly more likely to be women, younger, have a shorter smoking history and a higher FTND score (all p<0.05). After 3 months of varenicline treatment, the smokers with psychiatric disorders had a significantly lower point smoking cessation rate (12.4% vs. 27.3%, p=0.012) and a lower percentage of daily reduced cigarette consumption (54% vs. 68%, p=0.02). The most commonly reported adverse events were nausea, without any group difference.


The smokers with psychiatric disorders had a lower point smoking cessation rate than the smokers without psychiatric disorder after 12-week varenicline treatment. The development of novel tobacco treatments program integrated with psychiatric management for these patients is required.

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