A Literature Review of the Effectiveness of Varenicline vs. Nicotine Patches in Adult Smoking Cessation

DeCoste, Robert, Karin Lewandowski, Jennifer Whaley, and Joyce Conley

A LITERATURE REVIEW OF THE EFFECTIVENESS OF VARENICLINE VS. NICOTINE PATCHES IN ADULT SMOKING CESSATION

 

DeCoste, Robert*; Lewandowski, Karin*; Whaley, Jennifer*; Conley, Joyce PhD. RN, UDM College of Health Professions faculty

 

STATEMENT OF THE PROBLEM

With a large population of cigarette smokers in the United States, it is necessary for medical professionals to be able to aid patients in smoking cessation.  For this purpose, a number of pharmacological products are available.  The objective of this literature review was to determine the relative effectiveness of Chantix (varenicline) when compared to Nicoderm CQ (nicotine replacement patches) in adult smoking cessation.

 

CLINICAL QUESTION

In adult smokers, what is the effect of varenicline on success rate for complete smoking cessation compared with nicotine patches?

 

METHOD

A comprehensive search of PubMed, CINAHL, and MEDLINE was completed to find articles on the clinical question. The search resulted in a review of six articles, four of which were meta-analyses, and two of which were randomized controlled trials directly comparing the efficacy of the two interventions.

 

CRITICAL APPRAISAL OF EVIDENCE

Three of the four meta-analyses demonstrated the superiority of varenicline to nicotine replacement therapy in complete smoking cessation using indirect comparisons (both interventions were compared to placebo).  One randomized control trial demonstrated that varenicline increased smoking cessation rates, and decreased cravings, withdrawal symptoms, and smoking satisfaction when compared with nicotine patches.  The other randomized control trial demonstrated no statistically significant difference in smoking cessation between the two therapies, but found that side effects were greater in participants using varenicline.

 

ACCEPTED PRACTICE

Currently, no standard of practice has been established for smoking cessation by the World Health Organization, the Center for Disease Control, the American Heart Association, the American Cancer Society, or the Surgeon General.

 

CLINICAL PRACTICE IMPLICATIONS

Due to the lack of numerous randomized control trials directly comparing the efficacy of varenicline and nicotine replacement patches, more research is needed in this area before a definitive answer to our clinical question can be established.

Currently, when prescribing a patient an aid for smoking cessation, consideration must be given to the varying mechanisms of action of the products, and individualized treatment should be established.