Varenicline Facilitates Smoking Cessation in Smokers Who Are Unable to Stop Abruptly

Most smoking-cessation guidelines recommend abrupt cessation, rather than gradual reduction, despite the inability of many smokers to even contemplate such an approach. To determine whether gradual reduction with varenicline (Chantix) might be more effective for some smokers, researchers randomized ≈1500 smokers who were unwilling or unable to stop abruptly to varenicline (titrated to 1 mg twice daily) or placebo for 24 weeks. Participants received standard cessation counseling and were encouraged to reduce consumption by at least 75% by week 8, with the goal of eventual cessation. Smokers with a wide range of medical, psychiatric, and substance abuse diagnoses were excluded.

Overall study completion rate was about 70%. In the first 8 weeks …