Use of stop-smoking medications in the United States before and after the introduction of varenicline.

Aims To evaluate trends in use of stop-smoking medications ( SSMs) before and after varenicline ( Chantix™) was introduced to the market-place in the United States, and to determine whether varenicline reached segments of the population unlikely to use other SSMs. Design Cohort survey. Setting United States. Participants A nationally representative sample of adult smokers in the United States interviewed as part of the International Tobacco Control Four Country Survey between 2004 and 2011. Primary analyses used cross-sectional data from 1737 smokers who attempted to quit (∼450 per wave). Measurements Reporting an attempt to quit smoking; use of each of the following types of SSMs for the purpose of quitting smoking: nicotine gum, nicotine patch, other nicotine replacement therapy, bupropion and varenicline. Findings There was a significant increase in the rate of use of any SSM among quit attempters across the study period [odds ratio ( OR) = 1.15, 95% confidence interval ( CI) = 1.10-1.21 per year]. This increase was largest after varenicline was introduced ( OR = 1.16, 95% CI = 1.07-1.26 per year); however, there was a decline in nicotine patch use during this time ( OR = 0.87, 95% CI = 0.76-0.99 per year). Varenicline users were generally similar to users of other SSMs but differed from those who did not use any SSMs, in that they tended to be older ( OR = 5.46, P = 0.024), to be white ( OR = 2.33, P = 0.002), to have high incomes ( OR = 1.85, P = 0.005), to have high nicotine dependence prior to quitting ( OR = 2.40, P = 0.001) and to have used medication in the past ( OR = 3.29, P < 0.001). Conclusions The introduction of varenicline in the United States coincided with a net increase in attempts to quit smoking and, among these, a net increase in use of stop-smoking medications. The demographic profile of varenicline users is similar to the profile of those who use other stop-smoking medications and different from the profile of those who attempt to quit without any medication. [ABSTRACT FROM AUTHOR]