Cape Town - Smokers who are trying to quit may be more successful if they combine a nicotine patch with an anti-smoking prescription drug, Stellenbosch University and other South African researchers have found.
In the latest study, published in the Journal of the American Medical Association, researchers found that combining the smoking cessation medication varenicline with nicotine replacement therapy (NRT) was more effective than varenicline alone.
Varenicline works by reducing the urge to smoke and by relieving craving and withdrawal symptoms. Nicotine patches work in a similar manner by targeting nicotine receptors in the brain.
Varenicline is known by the trade name Chantix in the US and Champix in Europe and other parts of the world.
Analysing 435 smokers in seven sites in South Africa between April 2011 and October 2012, researchers found that there was a higher and continuous abstinence in the long term (between three and six months) among those on combination therapy than those on varenicline alone.
Participants between 18 and 75 years old who smoked at least 10 cigarettes a day during screening were followed up in the first 12 weeks and thereafter at intervals up to 24 weeks. Tobacco abstinence was established or biochemically validated and confirmed by exhaled carbon monoxide measurements.
In the study the continuous abstinence rate at three months was measured at 55.4 percent among smokers on the drug and the patch compared to the 41 percent on the drug only.
Smoking cessation programmes without medication are estimated to be successful in only one percent of smokers while programmes using cessation medications have about 30 percent success rate.
The country’s public health sector has no medicine-based cessation programmes. There are about 7 million smokers in South Africa. About 21 percent of them are pupils between grades 8 and 10.
Professor Elvis Irusen, a co-author of the study and head of pulmonology at Stellenbosch University, said giving up smoking was mostly a lifestyle choice, and after six months most patients relapsed either accidentally or got “hooked” again.
While researchers found that combination cessation therapy was more effective than using the drug alone, they also found those in the combination group experienced a greater incidence of side effects including nausea, sleep disturbances, skin reactions, constipation and depression, while those on varenicline alone reported abnormal dreams and headaches.
Researchers said while the combination therapy proved effective, further studies were needed to assess its long-term efficacy and safety.
Cape Argus