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.
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.
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
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