Medicines

Nicotine metabolism key to quitting


The success of different smoking cessation treatments could depend on how quickly smokers break down nicotine in their bodies, researchers say.

The pharmacogenetic study randomly assigned 1246 smokers (662 slow metabolisers of nicotine and 584 normal metabolisers) to 11 weeks of either a nicotine patch (plus a placebo pill), varenicline (Champix) (plus placebo patch), or a placebo pill and patch. All participants received behavioural counselling and were followed for 12 months after their quit date.

At the end of treatment normal metabolisers taking varenicline were about twice as likely to have quit as those using the nicotine patch, and were significantly more likely to still have quit six months later. Although varenicline was just as effective as nicotine patches at helping slow metabolisers to quit they reported more side-effects with the drug, said the study authors in their paper published in The Lancet Respiratory Medicine.

Should the findings be replicated, they might lead to changes in clinical practice through the implementation of prescriptions stratified on the basis of a biomarker test, an accompanying editorial said.

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