BACKGROUND: Varenicline is now very useful medication for cessation; however, there is only little result of researches with varenicline for cessation of hospitalized patients. This research attempted to analyze the cessation effect of medication and compliance of hospitalized patients. METHODS: This research included data for 52 patients who were prescribed varenicline among 280 patients who were consulted for cessation during their admission period. This research checked whether smoking was stopped or not after six months and analyzed their compliance, the factors for succeeding in smoking cessation. RESULTS: One hundred and ninety hospitalized patients participated in smoking cessation counseling among 280 patients who included consultation from their admission departments. And varenicline was prescribed for only 80 patients after counseling. Nineteen smokers were successful in smoking cessation among 52 final participants representing the rating of success of 36.5%. The linkage between compliance of varenicline and rate of smoking successful has no statistical significance. The factors for succeeding in smoking of hospitalized patients are admission departments, diseases, and economic states. CONCLUSION: Smoking cessation program has low inpatient compliance. Cooperation of each departments is very important for better compliance. Success rate of cessation was relatively high (36.5%). Cessation attempt during hospitalization is very effective strategy.
Compliance* ; Counseling ; Hospitalization ; Humans ; Inpatients ; Smoke* ; Smoking Cessation* ; Smoking* ; Varenicline

BACKGROUND: Varenicline, a selective partial agonist/antagonist of the alpha4beta2 nicotinic receptor, has proven effectiveness for smoking cessation by several randomized, controlled trials. Because few studies have evaluated the long-term efficacy of varenicline, we tried to evaluate the smoking status of varenicline users up to 3 years after the initial prescription of the drug. METHODS: We interviewed varenicline users who were prescribed the drug from June 2007 to May 2010 by telephone, from June 2010 to May 2011. RESULTS: One-hundred and thirty-three of 250 varenicline users (53.2%) were available for the survey. Seven-day continuous abstinence from smoking was adhered to by 17 of 39 respondents (43.6%) at 1 year, and 11 of 36 (30.6%) and 19 of 58 (32.8%) at 2 and 3 years since the first use of varenicline, respectively. Compared to current smokers, successful quitters were older (55.0 years vs. 49.9 years, p=0.01), had better compliance to the 12-week course (27.7 vs. 9.3%, p=0.01), and had taken varenicline longer (10.1 vs. 5.9 weeks, p=0.01). Fifty-four of 71 current smokers (76.1%) were willing to stop smoking in the near future. The preferred ways to cease smoking were will-power (48.1%), varenicline (25.9%), nicotine replacement therapy (11.1%), and others (14.9%). CONCLUSION: Smokers should be encouraged to stick to the proven way for recommended period of time for successful cessation of smoking.
Compliance ; Surveys and Questionnaires ; Nicotine ; Prescriptions ; Receptors, Nicotinic ; Smoke* ; Smoking Cessation ; Smoking* ; Telephone ; Varenicline

BACKGROUND: Varenicline is recently known as smoking cessation medicine has no results of researches conducted in the actual practice settings except for incipient clinical trials. This research attempted to analyze the factors for smoking cessation by using Varenicline prescribed in the family clinic, and the efficacy of Varenicline. METHODS: Brief smoking cessation education was conducted on 140 people who visited the Department of Family Medicine at Dankook University and Varenicline was prescribed for them. This research checked whether smoking was stopped or not after six months and analyzed the factors for succeeding in smoking cessation. RESULTS: Varenicline was prescribed for the 140 people. After six months, 46 smokers were successful in smoking cessation, representing the rate of success of 35.4%, and after 12 months, 31 people of 83 people were successful in smoking cessation, representing the rate of success of 37.3%. The group less smoke than 24.3 cigarettes/day (the average daily smoking amount) has higher quit rate than the group more smoke than 24.3 by 4.9 times. The group takes Varenicline longer than 26.7 days (the average Varenicline dosage period) has higher quit rate than the group takes Varenicline shorter than 26.7 by 4 times. Smoking-cessation rate was 4.5 times when trying to stop smoking by the doctor's recommendation. It was higher than when trying to stop smoking by self-determination. In the multivariate analysis, there were significant relationships in daily smoking amount, dosage and period of Varenicline, and motivation of visits. CONCLUSION: Varenicline is one of the useful medication for quitting smoking in family practice setting. Better compliance of medicine shows better quitting rate.
Benzazepines ; Compliance ; Family Practice ; Humans ; Motivation ; Multivariate Analysis ; Quinoxalines ; Smoke ; Smoking ; Smoking Cessation ; Varenicline

Craving has been well known to be the most important clinical phenomenon in smoking cessation treatment and one that physicians always encounter. For successful and prolonged abstinence, understanding, evaluation, and management of craving are essential. The concept and definition of craving is still under debate, although its importance, relevance, and role in smoking relapse is evident. There are two types of craving, 'abstinence-induced craving' and 'cue-induced craving' according to time dynamic and causes. The evaluation of craving mainly depends on self-reported measures in the clinical field. Pharmacological treatments such as the nicotine patch, bupropion, and varenicline are effective for abstinence-induced craving. Psychosocial treatment and a few pharmacological agents such as nicotine gum and lozenges are useful for reducing cue-induced craving. This review was aimed at conveying up-to-date information on the characteristics, evaluation, and treatment of craving. Development of objective measurement tool for evaluation of craving is needed. The effects of pharmacological treatments on 'cue-induced craving' remain to be discovered. An active effort to alleviate each type of craving is necessary to enhance and prolong a patient's abstinence.
Benzazepines ; Bupropion ; Gingiva ; Nicotine ; Quinoxalines ; Recurrence ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Use Cessation Products ; Tobacco Use Disorder ; Varenicline

BACKGROUND: Varenicline is an effective smoking cessation aid. However, smokers prescribed with varenicline do not always receive varenicline for 12 weeks, as recommended. This study analyzed the subjects who received varenicline and investigated the effect of varenicline treatment duration on the success rate of 6-month smoking cessation. METHODS: This study retrospectively analyzed 78 subjects, who received varenicline, out of the 105 smokers that had visited the smoking cessation clinic after medical examination from September 2007 to December 2009. RESULTS: The subjects were all males. Twenty-two subjects (28.2%) had varenicline treatment for 12 weeks or longer; 18 subjects (23.1%) for 8~12 weeks; 22 subjects (28.2%) for 4~8 weeks; and 16 subjects (20.5%) for less than 4 weeks. The total success rate of the 6-month smoking cessation was 47.4%. The success rate of the 6-month smoking cessation was 63.6% in the group that received varenicline for 12 weeks or longer, which was higher than 41.1% of the group that early terminated the varenicline treatment (p=0.074). The period of varenicline treatment was extended for one more week, the odds ratio of the 6-month smoking cessation success increased to 1.172-folds (p=0.004; 95% confidence interval, 1.052~1.305). Adverse events occurred in 30.8% of the subjects who received varenicline, but no serious adverse events were found. CONCLUSION: If varenicline treatment period is extended, the odds ratio of the success rate for the 6-month smoking cessation increases. Therefore, an effort to improve drug compliance for varenicline in clinical practices could be helpful for the long-term success of smoking cessation.
Benzazepines ; Compliance ; Health Promotion ; Humans ; Male ; Medication Adherence ; Odds Ratio ; Quinoxalines ; Retrospective Studies ; Smoke ; Smoking ; Smoking Cessation ; Varenicline

Objectives: To evaluate the cost-effectiveness of typical pharmaceutical smoking cessation intervention strategies in China in the context of primary cancer prevention. Methods: Markov cohort simulation models were established to simulate the burden of 12 smoking caused cancer, including lung cancer, oral cancer, nasopharyngeal cancer, laryngeal cancer, esophageal cancer, gastric cancer, pancreatic cancer, liver cancer, kidney cancer, bladder cancer, cervical cancer, and acute myeloid leukemia. Taking incremental cost effectiveness ratio (ICER) as the main indicator, the model sets one year as the cycling period for 50 periods and simulates the cohort of 10 000 thirty-five-year-old current smokers with various smoking cessation strategies. To ensure the robustness of conclusion, univariate sensitivity analysis, probability sensitivity analysis, and age-group sensitivity analysis were conducted. Results: The results showed that varenicline intervention was the most cost-effective intervention. Compared to the next most effective option, incremental cost of each additional quality-adjusted life year is 11 140.28 yuan, which is below the threshold of willingness to pay (1 year GDP per capita). The value of ICER increased as the increasing age group of adopting intervention, but neither exceeded the threshold of willingness to pay. One-way sensitivity analysis showed that the value of discount rate, the hazard ratio and cost of intervention strategy had a greater impact on the result of ICER. Conclusion: In China, the use of varenicline to quit smoking is highly cost effective in the context of cancer primary prevention, especially for younger smokers.
Humans ; Cost-Benefit Analysis ; Smoking Cessation ; Cost-Effectiveness Analysis ; Nasopharyngeal Neoplasms ; Varenicline ; China ; Kidney Neoplasms ; Pharmaceutical Preparations

Schizophrenia is a major chronic mental illness with various symptoms that is often accompanied by substance use disorders. Patients with schizophrenia have a higher smoking rate than the general population and a lower smoking cessation success rate. Further, their motivation for smoking cessation is often low. Individuals with schizophrenia that are past or present cigarette smokers are more difficult to treat in terms of psychotic symptoms, are more likely to have physical illnesses, and have higher mortality rates. A variety of treatments, both pharmacological and non-pharmacological, are used to aid smoking cessation in patients with schizophrenia. Among these, bupropion, varenicline, and nicotine replacement therapy can be safely used in patients with schizophrenia, and several studies have demonstrated their effects. Cigarette smoking is an important health problem. The study of smoking cessation in individuals with schizophrenia may help improve their ability to function and their quality of life through active evaluation and treatment.
Bupropion ; Drug Therapy ; Humans ; Mortality ; Motivation ; Nicotine ; Quality of Life ; Schizophrenia ; Smoke ; Smoking Cessation ; Smoking ; Substance-Related Disorders ; Tobacco Products ; Varenicline

BACKGROUND: Although the number of medical institutions running a smoking cessation clinic is on the rise, there remains a paucity of research on the long- and short-term success rates of smoking cessation programs, as well as on smoking relapse rates, before and after project implementation. This study assessed the general characteristics of patients visiting the smoking cessation clinic, success rate of smoking cessation in the short term, and risks of relapse. METHODS: Medical records from March 2015 to April 2017 were analyzed and telephone surveys were conducted with 151 smokers who visited a hospital smoking cessation clinic from March 2015 to April 2017. RESULTS: Of the 139 smokers who were eligible for follow-up, 22 (15.8%) failed to quit smoking initially. The clinic's 6-month success rate of smoking cessation was 64.83%. Those with higher medication compliance had a lower risk of primary failure (odds ratio, 0.056; 95% confidence interval, 0.005–0.609), whereas those with higher age (hazard ratio [HR], 0.128; P=0.0252) and a greater number of visits to the clinic (HR, 0.274; P=0.0124) had a lower risk of relapsing. CONCLUSION: The risk of primary failure to quit was higher with low medication compliance, and that of relapsing was higher with lower age and fewer number of clinic visits. Various evaluation and analysis methods can be carried out in the future based on the accumulated data for maintenance of smoking cessation and relapse prevention.
Ambulatory Care ; Follow-Up Studies ; Humans ; Medical Records ; Medication Adherence ; Recurrence ; Running ; Secondary Prevention ; Smoke ; Smoking Cessation ; Smoking ; Telephone ; Varenicline

Objectives: To evaluate the cost-effectiveness of typical pharmaceutical smoking cessation intervention strategies in China in the context of primary cancer prevention. Methods: Markov cohort simulation models were established to simulate the burden of 12 smoking caused cancer, including lung cancer, oral cancer, nasopharyngeal cancer, laryngeal cancer, esophageal cancer, gastric cancer, pancreatic cancer, liver cancer, kidney cancer, bladder cancer, cervical cancer, and acute myeloid leukemia. Taking incremental cost effectiveness ratio (ICER) as the main indicator, the model sets one year as the cycling period for 50 periods and simulates the cohort of 10 000 thirty-five-year-old current smokers with various smoking cessation strategies. To ensure the robustness of conclusion, univariate sensitivity analysis, probability sensitivity analysis, and age-group sensitivity analysis were conducted. Results: The results showed that varenicline intervention was the most cost-effective intervention. Compared to the next most effective option, incremental cost of each additional quality-adjusted life year is 11 140.28 yuan, which is below the threshold of willingness to pay (1 year GDP per capita). The value of ICER increased as the increasing age group of adopting intervention, but neither exceeded the threshold of willingness to pay. One-way sensitivity analysis showed that the value of discount rate, the hazard ratio and cost of intervention strategy had a greater impact on the result of ICER. Conclusion: In China, the use of varenicline to quit smoking is highly cost effective in the context of cancer primary prevention, especially for younger smokers.
Humans ; Cost-Benefit Analysis ; Smoking Cessation ; Cost-Effectiveness Analysis ; Nasopharyngeal Neoplasms ; Varenicline ; China ; Kidney Neoplasms ; Pharmaceutical Preparations

BACKGROUND: Varenicline is known to have higher effect for smoking cessation than existing pharmacotherapies, including Bupropion and Nicotine replacement therapy, however, it can also bring about adverse effects such as problems in compliance due to the complicated dosage, side effects of high frequency, and financial burden resulted from a long term treatment. Moreover, the effect for smoking cessation with group program and non-pharmacotherapy, including financial incentives, E-mails or SMS is well known, but, the study on their combination is rare. Therefore, in the present study, we tried to evaluate two things; the effect for smoking cessation with multi-modal intervention, and the compliance of Varenicline. METHODS: From July 2008 to February 2009, we conducted the multi-modal smoking cessation program for 30 volunteers in Dankook university. This program consisted short course of Varenicline, financial incentives, E-mail and short message service. RESULTS: The continuous abstinence rate for weeks 9 throught 12 was 76.7% and for weeks 9 through 24 was 43.3%. Multivariate analysis revealed that duration of Varenicline treatment was significant factor affecting 12-week continuous abstinence rate. The average duration of Varenicline treatment was 17.1 (+/-10.8) days and 54.0% took Varenicline as directed. The most common adverse events were nausea (40.0%) and insomnia (23.3%). CONCLUSION: Multi-modal intervention (short course of Varenicline, financial incentive, E-mail and short message service) was effective for smoking cessation with high continuous abstinence rates in a university. We suggest multi-modal intervention because compliance of Varenicline seems to be low in real setting.
Benzazepines ; Bupropion ; Compliance ; Electronic Mail ; Motivation ; Multivariate Analysis ; Nausea ; Nicotine ; Quinoxalines ; Sleep Initiation and Maintenance Disorders ; Smoke ; Smoking ; Smoking Cessation ; Text Messaging ; Varenicline