Comparison of the Effectiveness of Varenicline, Extended-Release Bupropion and Nicotine Replacement Therapy on The Success and the Maintenance of a Smoking Cessation Program

Objectives: The most effective approach for individuals who decide to stop tobacco smoking is behavioral training complemented with motivational support and pharmacological therapy. This study aims to compare the effects of varenicline, extended-release bupropion and nicotine replacement therapy (NRT) on the success and the maintenance of a smoking cessation program.Methods: 300 consecutive patients from a smoking cessation clinic, whose nicotine dependence was confirmed, were evaluated in a randomized manner. 251 patients completed the study. In this study, we used the Fagerström nicotine dependence test, a semi-structured clinic interview and the Hospital Anxiety and Depression scale (HAD) for clinical follow-up. Carbonmonoxide (CO) levels of the patients were measured with a carboxymeter. Patients had used the determined randomised pharmacological treatment option for 12 weeks.Results: There were no significant differences between the therapy groups according to age, gender and education levels (p > 0.05). Smoking cessation rates were 57.1% in the bupropion group (n= 77), 54.8% in the NRT group (n=73) and 72.3% in the varenicline group (n=101). Fagerstöm scores and the number of cigarettes consumed per day in the NRT group were significantly lower than those of the other therapy groups (p =0.002). There was a significant decrease compared with the initial measurements in the HAD-A 12-week scores in the bupropion and NRT groups (p=0.001 and p=0.003, respectively).Conclusions: According to our findings, 61.8% of all patients participating in this study continued the smoking cessation behavior during the 12 week follow-up period. It seems that varenicline is better than the other pharmacological therapy modalities for smoking cessation programs. The lower anxiety scores in the bupropion and NRT groups might have increased their success rates.