| Summary: | Introduction
Greater understanding is required of how smokers with smokingrelated
diseases respond to smoking cessation medications. This post hoc analysis
of EAGLES data compared continuous abstinence rates (CARs) in smokers with/
without smoking-related diseases and assessed participant demographic and
baseline characteristics that may serve as predictors of continuous abstinence (CA).
Methods
EAGLES was a 24-week (12-week treatment, 12-week follow-up), doubleblind,
active- (nicotine replacement therapy; patch) and placebo-controlled study
in motivated-to-quit smokers with/without psychiatric disorders. This analysis
assessed CARs at weeks 9-12 (CAR9-12) and 9-24 (CAR9-24) in participants
with smoking-related diseases [asthma, chronic obstructive pulmonary disease
(COPD), diabetes, and/or cardiovascular disease (n=1372)] versus controls
without these comorbidities (n=6039). Participants received varenicline 1 mg
twice daily, bupropion 150 mg twice daily, nicotine patches 21 mg/day with taper,
or placebo for 12 weeks. Stepwise logistic modeling was also performed to analyze
odds ratio (OR) for predictors of CA at weeks 9-12 (CA9-12) and 9-24 (CA9-24).
Results
Smokers with smoking-related diseases were older, had a longer smoking
history, more quit attempts, and were more likely to have a psychiatric disorder
and reside in the US versus smokers without comorbidities. Fagerström Test for
Cigarette Dependence scores and treatment adherence were comparable between
cohorts. Smokers with smoking-related diseases had lower CARs versus controls
(CAR9-12: 20.8% vs 24.0%; CAR9-24: 13.0% vs 16.9%). Use of smoking cessation
medication was the strongest predictor of CA after control for demographics,
smoking characteristics, and psychiatric disorder. By treatment, OR and CI were:
varenicline CA9-12 (OR=3.82; 95% CI: 3.21-4.54) and CA9-24 (OR=2.92; 95%
CI: 2.40-3.54); bupropion CA9-12 (OR=2.17; 95% CI: 1.81-2.60) and CA9-24
(OR=1.99; 95% CI: 1.63-2.44); nicotine patches CA9-12 (OR=2.23; 95% CI:
1.87-2.67) and CA9-24 (OR=1.86; 95% CI: 1.52-2.28).
Conclusions
Smokers with smoking-related diseases had lower quit rates than
controls. Of the active treatments compared, varenicline was most effective in
smokers with asthma, COPD, diabetes, or cardiovascular disease.
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