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Research: the benefit of smoking cessation drugs reaches only 8%

According to a new study conducted at Tel Aviv University, the benefit from smoking cessation drugs reaches only 8% one year after the start of treatment. Dr. Leah Rosen, head of the research team: "Preventing entry into the cycle of smoking addiction is the best medicine. There is an urgent need to promote initiatives to prevent the initiation of smoking among teenagers and young adults."

Illustration: Sophie Riches / Wikimedia Commons.
Illustration: Sophie Riches / Wikimedia Commons.

Researchers at Tel Aviv University, led by Dr. Leah Rosen from the Department of Health Promotion at the School of Public Health at Tel Aviv University's Faculty of Medicine, found that the effectiveness of common smoking cessation medications decreases during the first year after treatment begins.

The study was attended by: Prof. Lawrence Friedman from the Gartner Institute and the Department of Health Promotion at the School of Public Health, Dr. Tal Galili from the Faculty of Exact Sciences, as well as Dr. Jeffrey Cote and Dr. Mark Goodman, graduates of the Tel Aviv University School of Medicine. The article was recently published in the journal Addiction.

"Cigarette smoking is the world's most common cause of premature death that can be prevented," says Dr. Rosen. "A variety of smoking cessation medications have been approved by the US Food and Drug Administration (FDA), and their effectiveness has been proven in controlled clinical studies conducted over a limited period of time. However, their usefulness over time remains an open question. We asked to examine this issue with an emphasis on the question of whether there was a decrease in the benefit of providing drug treatment during participation in the experiment."

The researchers used statistical methods of meta-analysis (statistical analysis of several studies together) to examine the results of 61 controlled studies from the international scientific literature, which included nearly 28,000 smokers who wanted to quit smoking. The studies examined the effectiveness of three common drugs approved by the FDA (first-line drugs): Zeivan (active ingredient: bupropion), nicotine replacements, and Champix (active ingredient: varenicline). In all studies, the participants were randomly divided into groups: some received an active drug, and some did not receive an active drug (the control group). Also, in most of the studies all participants - both in the intervention group and in the control group - were also offered face-to-face or telephone counseling sessions.

The study revealed the following data: about 40% of the participants who received active drugs did not return to smoking 3 months later. 6 months later the proportion of non-smokers dropped to only 25%. One year after the start of the treatment, about 20% of the drug recipients persisted in abstaining from smoking, compared to about 12% of the participants in the control group. This means that if we take into account the difference in smoking cessation rates between those receiving the active drugs and the control group, only 8% of smokers who received smoking cessation drugs continued to benefit from them one year after the start of treatment.

Dr. Leah Rosen explains that the uniqueness of this study differs in two main aspects from previous studies that examined the scientific literature using meta-analysis methods: 1. It examined smoking cessation rates at different time points separately; 2. He assessed the decrease in benefit from the drugs over time.

Currently, smoking cessation treatments are included in the Israeli health basket. The health funds provide their members with free smoking cessation workshops, and workshop participants are entitled to smoking cessation medications at a reduced price. The drugs Champix and Zyvan are considered first-line drugs for smoking cessation, and nicotine replacements are considered second-line drugs. In December 2017, telephone counseling to stop smoking was also added to the medicine basket, and smokers who use the telephone line are also entitled to a discount on the purchase of medicines.

"According to our findings, 8 out of every 100 smokers did benefit from the smoking cessation medications, and this fact justifies the continuation of efforts in drug treatment," concludes Dr. Rosen. "However, it is clear that this is not enough. Much more needs to be done to reduce smoking among the population, and reduce the enormous damage it causes. We believe that it is imperative to find more beneficial methods to help smokers quit smoking for good, and we appreciate the FDA's efforts to develop more effective medical nicotine for smokers who want to quit smoking. In addition, the policy makers must use all means to prevent the initiation of smoking at a young age. Preventing entry into the cycle of addiction is the best medicine."

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