Anti-smoking drug improves chances.

• Position: Quitting the Habit - Varenicline

Smokers have a higher probability of quitting smoking and a better overall cessation experience when taking varenicline compared to bupropion and to placebo--unmedicated assisted smoking cessation--according to a study published in the journal JAMA Psychiatry.

A team led by behavioral scientist Paul Cinciripini investigated the relative efficacy of varenicline and bupropion--both popular anti-smoking drugs on the market--plus intensive counseling to assess the drugs' effects on smoking-cessation and emotional functioning while quitting.

"National surveys show that about 20% of adults continue to smoke, but It's disproportionally high among people in low socioeconomic populations and those with mental illness," says Cinciripini. 'When smokers try to quit, many are likely to experience a range of nicotine withdrawal symptoms, including negative mood, difficulty concentrating, irritability, and even depressive symptoms, which makes quitting difficult and increases the chances of relapse.

"Our findings suggest that smokers trying to quit will have a better experience with varenicline as opposed to trying to quit on their own or by taking bupropion. The more we can reduce these negative symptoms associated with quitting, the better the experience of the smoker and this may mean that even if they don't quit this time, they will be encouraged to try again."

The researchers used four different measurements of abstinence and found that only varenicline significantly improved abstinence rates by all measures at all time periods.

When measuring the effects of abstinence alone on emotional functioning, the study found that regardless of which medication the smoker received, people who were able to abstain from smoking had lower scores for overall negative effect, anxiety, and sadness, but also showed higher positive effect.

"This is a very interesting finding in that it suggests smoking itself may not be a very good anti-depressant," notes Cinciripini. "It also suggests that those who were able to abstain from smoking will ultimately feel better than those who continue to smoke."

The study also found that, compared to the nonabstainers, abstainers using either bupropion or varenicline experienced lower levels of sadness but, in terms of overall depressive symptoms, the...