Knowing that smoking cigarettes is typically harmful for your health, a number of smokers try to stop. This is not always easy, so it has been a real help for many people to take a medication to help them stop smoking
Nicotine is the primary ingredient in tobacco that stimulates a pleasure center in the brain. As a result, some people become addicted to nicotine.
Two common treatment approaches to stop cigarette smoking involves two different medications along with counseling.
Neither medication eliminates cigarette smoking in everyone who takes one of them. Cinciripini and colleagues wanted to find out what the best strategy is when smoking cessation attempts with one of these medications doesn’t work.
They studied 490 smokers who were given one of two medication treatments: varenicline (2 mg per day) or a combination of oral nicotine (2 mg lozenges) and nicotine patches (21 mg patches).
They took their medication for 6 weeks. Participants who failed to stop smoking were randomly assigned to one of 3 treatment options: 1. Continue the same medication at the same dose; 2. Increase the dose of the medication they were on; or 3. Switch to whichever medication they were not on.
The researchers wrote about the results in JAMA Online on May 2, 2024. “Increasing the dosage led to the greatest benefit for those originally taking varenicline, whereas those receiving nicotine replacement therapy benefitted similarly from the dosage increase or switching to varenicline …”
The researchers also noted that there was an indication that increasing the dose of the nicotine replacement may “provide longer-term benefit” than switching to varenicline.
Varenicline is a medication that blocks a receptor in the brain that lights up the pleasure center when stimulated by nicotine. As a result, nicotine does not stimulate the pleasure center when smoking.
One thing I took from this research is that there are helpful things you can do if your initial treatment for cigarette smoking is not working.
If you are interested in reading the research paper itself, type this in a search bar:
doi:101001/jama.2024.4183
Peter M. Hartmann, MD
Family Medicine & Psychiatry
