Updated 08 January 2014

Chantix helps mentally ill smokers to quit

A study indicates that the smoking cessation drug Chantix may help people with mental illness who are trying to quit avoid a relapse.

For people with serious mental illness who are trying to quit smoking, extending their treatment with the smoking cessation drug Chantix (varenicline) may help them avoid a relapse, according to a new study.

After a standard 12-week course of treatment with the drug, study participants who quit smoking continued to receive the drug along with a type of treatment that helps alter behaviour, called cognitive behavioural therapy, for another 40 weeks. After receiving the extended treatment, they were three times more successful in avoiding cigarettes than those who only received the behavioural therapy and a placebo (fake) pill, the study found.

"We know that relapsing to smoking is a big problem for smokers without psychiatric illness, but relapsing after a course of smoking cessation medication appears to happen even more rapidly in those with schizophrenia and related disorders," study author Dr Eden Evins, director of the Massachusetts General Hospital Centre for Addiction Medicine, said in a hospital news release.

Read: Chantix helps smokers quit

Important source of stigma

"Maintenance therapy to help these patients sustain abstinence could reduce an important source of stigma, along with their heavy burden of smoking-related illness," Evins said.

In contrast with other US adults, the prevalence of smoking among those with serious mental illness is even higher now than it was in 1965, the study authors said. Yet, while most people with schizophrenia or bipolar disorder smoke, adults with serious mental illness are rarely offered even a standard course of medication to help them stop smoking, the researchers pointed out in the news release.

The new study, published in the issue of the Journal of the American Medical Association, involved 203 patients being treated at 10 mental health centres in six states for schizophrenia, a related condition known as schizoaffective disorder or bipolar disorder.

During the first 12 weeks of treatment, the participants received a daily dose of Chantix (a prescription drug) and weekly group behavioural therapy sessions.

Of the 203 participants, 87 were considered to be abstinent. These patients were randomly assigned to continue to receive Chantix or a placebo for an additional 40 weeks. Although both groups continued to receive behavioural therapy, these sessions became less frequent over the course of the 12-month study.

Read: Chantix quadruples a smoker's odds of kicking the habit

Benefits of behavioural therapy

Based on self-reporting and levels of exhaled carbon monoxide, the researchers found that 60% of the participants who received the extended treatment with Chantix remained abstinent. Meanwhile, 19 percent of the placebo group had managed to continue to avoid cigarettes.

Half of those in the placebo group smoked within 35 days of stopping the drug. In contrast, it took nearly one year for half of those in the Chantix group to relapse, the investigators found.

Although behavioural therapy alone was not enough to prevent relapse in the placebo group, the researchers pointed out that most of the patients in the Chantix group who relapsed did so after the behavioural therapy was cut back. They concluded that behavioural therapy likely plays a supportive role in treatment with Chantix.

The researchers said more studies are needed to examine the effectiveness of combinations of treatment involving medication and other forms of behavioural support, such as telephone quit lines.

Read More:

Suicidal anti-smoking drug

Smoking cessation drugs OK for heart


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