A recent clinical trial conducted by Monash University has revealed that combining varenicline with nicotine lozenges can significantly enhance smoking cessation outcomes compared to using varenicline alone. The research, published in JAMA Network Open, highlights a promising new treatment strategy for smokers aiming to quit.
Varenicline and nicotine lozenges, a type of nicotine replacement therapy, are well-established smoking cessation aids. Varenicline, in particular, is recognized as the most effective single treatment currently available.
The trial, named “VANISH” (Varenicline And NIcotine replacement therapy for Smokers admitted to Hospitals), involved 320 hospitalized adult smokers. It demonstrated that those treated with both varenicline and nicotine lozenges had an 84% higher chance of reporting smoking abstinence after 12 months compared to those who only used varenicline.
According to lead author, Associate Professor Johnson George, this is the first reported placebo-controlled, randomized clinical trial to compare the efficacy and safety of varenicline alone versus in combination with nicotine lozenges in hospitalized heavy smokers.
Despite the COVID-19 pandemic limiting the ability to measure biochemically validated abstinence, the self-reported data indicated that the combination therapy was significantly more effective than varenicline alone, without compromising safety.
Professor George emphasized the importance of introducing nicotine lozenges in the treatment regimen of heavy smokers as it will help manage withdrawal symptoms.
Smoking remains the leading cause of preventable disease and death in Australia. Although the number of tobacco smokers has decreased over recent decades, the rise of e-cigarettes and vaping has led to a new wave of nicotine addiction. George stressed that vaping is not a suitable evidence-based smoking cessation strategy, and the availability of more alternative options like the combination of varenicline and nicotine lozenges is crucial.
The study focused on hospitalized heavy smokers due to the significant health benefits of smoking cessation for this group, which impacts the broader community and healthcare systems. However, researchers suggest that future research should include larger clinical trials to measure biochemically validated abstinence of the combination therapy.