2007 National Conference on Tobacco or Health

Thursday, October 25, 2007
Exhibit Hall

Effect of Nicotine Dependence Level on Quit Outcomes with Varenicline

Elbert D. Glover, PhD, University of Maryland, Center for Health Behavior Research, eglover1@umd.edu, Susan Swartz, MD, swarts@mmc.org, David Gonzales, PhD, gonzales@ohsu.edu, Clare B. Billing Jr, MS, bill.billing@pfizer.com, Kathryn E. Williams, PhD, kathryn.e.williams@pfizer.com.

Learning Objectives: Describe quitting outcomes of varenicline versus placebo based on data from subgroups with different levels of nicotine dependence at baseline

Problem/Objective: Smokers' nicotine dependence levels may influence quitting outcomes. Quitting rates for varenicline, a pharmacotherapy designed for smoking cessation, were evaluated to determine whether baseline nicotine dependence influences quitting. Methods: Pooled data were analyzed from 3 randomized, double-blind, multicenter trials. Subjects received varenicline 1mg BID (n=945) or placebo (n=805) for 12 weeks, followed by 40 weeks non-drug follow-up. The primary endpoint was carbon monoxide-confirmed, 4-week continuous abstinence rate (CAR) for Weeks 9-12, which was 45.9% for varenicline and 16.9% for placebo (odds ratio [OR] 4.13; 95% confidence interval [CI] 3.29, 5.18). Outcomes were analyzed by Fagerström Test for Nicotine Dependence (FTND) score representing mild (0-3), moderate (4-6), and severe (7-10) dependence, and by cigarettes per day (CPD) representing, low (<20), medium (20-<30), and high (≥30) smoking levels. Results: For all FTND scores, Week 9-12 CAR was greater for varenicline than placebo: mild 55.1% vs 18.9% (OR 5.49; CI 3.38, 8.93); moderate 48.4% vs 20.7% (OR 3.42; CI 2.50, 4.67); and severe 35.9% vs 9.6% (OR 5.28; CI 3.25, 8.59). Similarly, Week 9-12 CAR by CPD was higher for varenicline than placebo: low 52.2% vs 22.8% (OR 3.64; CI 2.49, 5.32); medium 44.9% vs 14.4% (OR 4.76; CI 3.37, 6.62); and high 39.5% vs 14.3% (OR 3.85; CI 2.32, 6.38). Effects persisted on CAR to Week 52 by FTND score and CPD. Conclusions: As the treatment effect was similar for each FTND and CPD subgroup, these data suggest that varenicline is efficacious for smoking cessation regardless of nicotine dependence at baseline.