LA JOLLA, Calif. — Medications purported to help people quit smoking often aren’t effective by themselves and should be coupled with behavioral counseling, according to a study released Wednesday by the UC San Diego School of Medicine.
The results of the study, published online in the Journal of the National Cancer Institute, came despite promise shown by such drugs during clinical trials.
The researchers evaluated varenicline, bupropion and nicotine replacement therapy via a patch, with data from the Current Population Survey- Tobacco Use Supplement — a U.S. Census survey of adults 18 years or older conducted to obtain information about the country’s use of tobacco products.
“Thirty-four percent of people who are trying to quit smoking use pharmaceutical aids and yet most are not successful,” said senior study author John Pierce, professor emeritus in the Department of Family Medicine and Public Health at UCSD. “The results of randomized trials that tested these interventional drugs showed the promise of doubling cessation rates, but that has not translated into the real world.”
The clinical trial results might have been skewed by intensive behavioral counseling used by test subjects, the researchers said.
Prior research that studied the effect of free behavioral counseling offered by phone has shown improvement in smoking cessation rates when combined with medication.
“Smokers who are committed to quitting and want to use a pharmaceutical aid should also enroll in a program that could help them track their progress and support them in their attempt,” said Eric Leas, who conducted the research while a graduate student researcher at UCSD and is now a postdoctoral scholar at the Stanford University School of Medicine.
Leas said the study results were surprising, given the promise of smoking cessation seen in randomized trials, and disappointing because of the need for interventions to help smokers quit.
Pierce added that evidence points to an important role of behavioral counseling when prescribing medication to stop smoking.
“If the products were approved with counseling we may have better success rates,” Pierce said. “As it is, less than 2 percent of smokers who use a pharmaceutical aid are using any behavioral counseling. In both of these longitudinal studies, this was a recipe for relapse to smoking.”
The research was paid for, in part, by the National Heart, Lung and Blood Institute and the Tobacco Related Disease Research Program, funded by tobacco taxes and administered by the University of California.