Is Varenicline Able to Prevent Smoking Cessation Induced Affective Symptoms?

The selective alpha4-beta2 nicotinic acetylcholine receptor (nAChR) partial agonist varenicline has been shown to be effective in the treatment of tobacco dependence by counteracting withdrawal symptoms and reducing smoking reward. However, the need to test safety, especially in smokers with varying co-morbidities and risk patterns is highlighted. There are some publications reporting exacerbation of psychiatric symptoms in subjects with pre-existing psychiatric disorders associated with varenicline treatment.This case-report describes a patient whose several smoking cessation attempts led to enduring nicotine-related symptoms such as depression and suicidal tendencies. All further cessation attempts under medical control with nicotine patches, bupropion and psychotherapy failed. At lest reducing her daily dose by one cigarette already led to suicidal thoughts. We took her into inpatient treatment and started an uptitration with varenicline. Unlike earlier attempts there were no complications during the detoxication and depressive symptoms improved clearly.Affective symptoms like depression are known to develop during nicotine cessation. The improving of affective symptoms in this case might be a result of the partial agonistic effects of varenicline.

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Analysis of the Cochrane Review: Electronic Cigarettes for Smoking Cessation and Reduction. Cochrane Database Syst Rev. 2014,12: CD010216.

Acta Médica Portuguesa ◽

10.20344/amp.6537 ◽

2015 ◽

Vol 28 (2) ◽

pp. 145 ◽

Cited By ~ 4

Author(s):

António Vaz-Carneiro ◽

João Costa

Keyword(s):

Smoking Cessation ◽

Behavioral Interventions ◽

Respiratory Diseases ◽

Electronic Cigarettes ◽

Cochrane Review ◽

Clinical Effectiveness ◽

Tobacco Dependence ◽

Cochrane Database ◽

Reasonable Evidence ◽

Treatment Of Tobacco Dependence

<p>Smoking is one of the most important risk factors for various cardiovascular, cancer and respiratory diseases. There are a number of smoking cessation techniques involving psychological, pharmacological and behavioral interventions, with varying effectiveness and different costs. The electronic cigarettes are devices which produce a nicotine aerosol but without the toxic products of tobacco smoke, and they have become popular as a potential intervention for smoking cessation. The present review analyzed the evidence published of this approach for the treatment of tobacco dependence and concluded that there is reasonable evidence of its clinical effectiveness. We present and discuss the findings of this systematic review, with practical contextualization.</p>

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Treatment of Tobacco Dependence Syndrome in Cancer Patients

Journal of Global Oncology ◽

10.1200/jgo.18.63500 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 22s-22s

Author(s):

I. Przepiórka ◽

M. Cedzyńska ◽

P. Koczkodaj ◽

M. Mańczuk

Keyword(s):

Smoking Cessation ◽

Behavioral Change ◽

Tobacco Dependence ◽

Behavioral Changes ◽

Pilot Program ◽

Telephone Support ◽

Main Motivation ◽

Oncology Center ◽

Treatment Of Tobacco Dependence

Background: The treatment of tobacco dependence is still not included in routine cancer care in Poland. We have developed a comprehensive program aimed at introducing tobacco dependence treatment as a standard procedure of cancer treatment. The pilot program was implemented in 2015 in two Polish cities: in Maria Sklodowska-Curie Institute - Oncology Center in Warsaw and in Oncology Centre in Bialystok. After two years we started follow-up of the program. Aim: To present the results of conducted follow-up study of the treatment of tobacco dependence pilot program in Poland. Methods: The pilot smoking cessation program was implemented in 2015. Tobacco dependent patients treated in the Maria Sklodowska-Curie Institute- Oncology Center in Warsaw and Oncology Center in Bialystok participated in course of medical and psychological counseling in smoking cessation clinic and through telephone support sessions. After two years we have conducted follow-up. We reached follow-up rate of 77%. Followed-up patients were asked about behavioral changes concerning smoking and main motivation to quit smoking. The data concerning smoking cessation were collected during telephone sessions. Based on that we analyzed indicators of treatment effectiveness. Results: In pilot program 87% of participating patients implemented a behavioral change, 70% of participating patients made a quit attempt, 55% reduced smoking, and 35% stopped smoking completely after intervention. After two years 30% of participating patients are not smoking and 40% reduced smoking. 85% of patients, who have maintained the behavioral change have used a pharmacological treatment and participated in all of available procedures (medical advices, psychological counseling sessions and telephone support sessions). As main motivation for quitting, 90% patients declared state of health (including cancer diagnosis) and pressure of family members (65%). Conclusion: High percentage of cancer patients who have reduced the number of smoked cigarettes or stopped smoking indicates that specialist support increases chance to make positive behavioral changes, or even stop smoking completely. The results of the study show that cancer diagnoses can be a very teachable moment, and it is recommended that health care providers use this opportunity and offer smoking cessation help to their patients.

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Efficacy of Varenicline, an α4β2 Nicotinic Acetylcholine Receptor Partial Agonist, vs Placebo or Sustained-Release Bupropion for Smoking Cessation: A Randomized Controlled Trial

Yearbook of Pulmonary Disease ◽

10.1016/s8756-3452(08)70598-x ◽

2008 ◽

Vol 2008 ◽

pp. 109-110

Author(s):

L.T. Tanoue

Keyword(s):

Randomized Controlled Trial ◽

Smoking Cessation ◽

Sustained Release ◽

Acetylcholine Receptor ◽

Nicotinic Acetylcholine Receptor ◽

Partial Agonist ◽

Controlled Trial ◽

Nicotinic Acetylcholine ◽

Randomized Controlled

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Varenicline, an α4β2 Nicotinic Acetylcholine Receptor Partial Agonist, vs Sustained-Release Bupropion and Placebo for Smoking Cessation: A Randomized Controlled Trial

Yearbook of Medicine ◽

10.1016/s0084-3873(08)70096-8 ◽

2007 ◽

Vol 2007 ◽

pp. 143-145

Author(s):

N.H. Hanna

Keyword(s):

Randomized Controlled Trial ◽

Smoking Cessation ◽

Sustained Release ◽

Acetylcholine Receptor ◽

Nicotinic Acetylcholine Receptor ◽

Partial Agonist ◽

Controlled Trial ◽

Nicotinic Acetylcholine ◽

Randomized Controlled

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Cytisine as an alternative smoking cessation product for Pacific smokers in New Zealand

Pacific Health Dialog ◽

10.26635/phd.2018.919 ◽

2018 ◽

Vol 21 (2) ◽

pp. 89-95

Author(s):

Vili Nosa ◽

Kotalo Leau ◽

Natalie Walker

Keyword(s):

Smoking Cessation ◽

New Zealand ◽

Nicotinic Acetylcholine Receptors ◽

Cultural Practices ◽

Partial Agonist ◽

Snowball Sampling ◽

Structured Interviews ◽

Liquid Form ◽

Pacific People ◽

The Pacific

ABSTRACT Introduction: Pacific people in New Zealand have one of the highest rates of smoking. Cytisine is a plant-based alkaloid that has proven efficacy, effectiveness and safety compared to a placebo and nicotine replacement therapy (NRT) for smoking cessation. Cytisine, like varenicline, is a partial agonist of nicotinic acetylcholine receptors, and blocks the rewarding effects of nicotine. Cytisine is naturally found in some plants in the Pacific region, and so may appeal to Pacific smokers wanting to quit. This paper investigates the acceptability of cytisine as a smoking cessation product for Pacific smokers in New Zealand, using a qualitative study design. Methods: In December 2015, advertisements and snowball sampling was used to recruit four Pacific smokers and three Pacific smoking cessation specialists in Auckland, New Zealand. Semi-structured interviews where undertaken, whereby participants were asked about motivations to quit and their views on smoking cessation products, including cytisine (which is currently unavailable in New Zealand). Interviews were recorded and transcribed verbatim, with thematic analysis conducted manually. Findings: Pacific smokers reported wanting to quit for loved ones and family, but did not find currently available smoking cessation products effective. Almost all participants had not previously heard of cytisine, but many of the Pacific smokers were keen to try it. Participants identified with cytisine on a cultural basis (given its natural status), but noted that their use would be determined by the efficacy of the medicine, its cost, side-effects, and accessibility. They were particularly interested in cytisine being made available in liquid form, which could be added to a “smoothie” or drunk as a “traditional tea”. Participants thought cytisine should be promoted in a culturally-appropriate way, with packaging and advertising designed to appeal to Pacific smokers. Conclusions: Cytisine is more acceptable to Pacific smokers than other smoking cessation products, because of their cultural practices of traditional medicine and the natural product status of cytisine.

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Relationship between insomnia and tobacco smoking in alcohol-dependent patients

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.460 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S398-S398

Author(s):

A. Wnorowska ◽

A. Jakubczyk ◽

A. Klimkiewicz ◽

A. Mach ◽

K. Brower ◽

...

Keyword(s):

Tobacco Use ◽

Tobacco Smoking ◽

Sleep Problems ◽

Psychiatric Symptoms ◽

Tobacco Dependence ◽

Multivariate Regression Analysis ◽

Brief Symptom Inventory ◽

Study Group ◽

The Relationship ◽

Alcohol Dependent

IntroductionInsomnia and tobacco use are frequent and important problems in alcohol-dependent patients. However, the relationship between sleep problems and cigarette smoking was not thoroughly investigated in this population.AimThe purpose of the study was to investigate the relationship between tobacco smoking and severity of insomnia in alcohol-dependent patients in treatment. We also aimed at assessing other predictors of insomnia in this population.MethodsThe study group comprised 384 alcohol-dependent patients. Standardized tools were used to assess: tobacco dependence (Fagerström Test for Nicotine Dependence [FTND]), sleep problems (Athens Insomnia Scale [AIS]), severity of alcohol dependence (Michigan Alcohol Screening Test [MAST]) and drinking quantities before entering treatment (Timeline Follow Back [TFLB]). Other comorbid psychiatric symptoms were assessed using Brief Symptom Inventory (BSI) and Barratt's Impulsiveness Scale (BIS-11).ResultsThe study group included 79.1% of current smokers, 62% of participants reported insomnia (AIS). The mean FTND score was 6.05 ± 2.18. The multivariate regression analysis revealed that the severity of tobacco dependence was significantly associated with the severity of insomnia (FTND, beta = 0.140, P = 0.013). Other factors associated with insomnia that remained significant in multivariate model were severity of psychopathological symptoms (BSI, beta = 0.422, P < 0.0005) and intensity of drinking (TLFB, beta = 0.123, P = 0.034).ConclusionTobacco use may predict severity of insomnia in alcohol-dependent patients. This finding may have important clinical implications and influence strategies applied in treatment of alcohol use disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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