Varenicline for long term smoking cessation in patients with COPD

Background: Quitting smoking is key for patients with Chronic Obstructive Pulmonary Disease (COPD). Standard recommendations for quitting smoking are implemented for COPD as well. Varenicline Tartrate (VT) is the most effective drug to help quit smoking, but few studies have analysed its effectiveness. Aim of the study: To determine the Abstinence Rate (AR) at 12 months, in COPD and non-COPD smokers. Methods: Observational study in 31 COPD (post bronchodilator-BD FEV1/FVC < 0.70) and in 63 non-COPD smokers, were invited to receive treatment with Varenicline Tartrate (VT). Fourteen subjects with COPD and 46 non-COPD subjects received additionally Cognitive-Behavioral Therapy (CBT). Abstinence rate (AR) was validated by exhaled carbon monoxide CO (COe), in addition to a phone or face-to-face interview. Motivation score was measured with a visual analogue scale (MS). Results: Differences between COPD and non-COPD, mean FEV1/FVC ratio 0.52 +/- 0.10 vs. 0.90 +/- 0.15, age 60 +/- 10 vs. 47 +/- 10 years, smoking pack-years 37 +/- 3.5 vs. 22 +/- 12, and COe 16 +/- 11 vs. 12 +/- 9 ppm were statistically significant (p < 0.05); for MS the score was 93 +/- 11 vs. 93 +/- 11 and for attempts to quit (AQ) 2 +/- 2 vs. 2 +/- 3 were not. AR was not significantly different at 12 months (61.2 vs. 42.8% p = 0.072). Motivation was the only significant one-year AR predictor. Conclusions: COPD smokers had a similar response (higher tendency) to VT regardless of the presence of airflow obstruction and stronger nicotine addiction.