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Use of smokeless tobacco is rising. In several trials, nicotine replacement and bupropion have been ineffective for treatment of patients who use smokeless tobacco. Varenicline (Chantix), a partial agonist of the nicotinic acetylcholine receptor, is effective in helping smokers to quit. In this double-blind randomized trial, industry-sponsored Scandinavian investigators assessed the efficacy of varenicline in helping adult smokeless tobacco users to quit.
At baseline, the 431 participants (mean age, 44; 89% men) reported average use of smokeless tobacco 15 to 16 times daily; average duration of use was longer than 20 years. Participants received varenicline or placebo for 12 weeks. The continuous abstinence rate at weeks 9 through 12 (confir…