Use of stop-smoking medications in the United States before and after the introduction of varenicline

Addiction. 2015 Feb;110(2):346-55. doi: 10.1111/add.12778. Epub 2014 Nov 20.


Aims: To evaluate trends in use of stop-smoking medications (SSMs) before and after varenicline (Chantix™) was introduced to the market-place in the United States, and to determine whether varenicline reached segments of the population unlikely to use other SSMs.

Design: Cohort survey.

Setting: United States.

Participants: A nationally representative sample of adult smokers in the United States interviewed as part of the International Tobacco Control Four Country Survey between 2004 and 2011. Primary analyses used cross-sectional data from 1737 smokers who attempted to quit (∼450 per wave).

Measurements: Reporting an attempt to quit smoking; use of each of the following types of SSMs for the purpose of quitting smoking: nicotine gum, nicotine patch, other nicotine replacement therapy, bupropion and varenicline.

Findings: There was a significant increase in the rate of use of any SSM among quit attempters across the study period [odds ratio (OR) = 1.15, 95% confidence interval (CI) = 1.10-1.21 per year]. This increase was largest after varenicline was introduced (OR = 1.16, 95% CI = 1.07-1.26 per year); however, there was a decline in nicotine patch use during this time (OR = 0.87, 95% CI = 0.76-0.99 per year). Varenicline users were generally similar to users of other SSMs but differed from those who did not use any SSMs, in that they tended to be older (OR = 5.46, P = 0.024), to be white (OR = 2.33, P = 0.002), to have high incomes (OR = 1.85, P = 0.005), to have high nicotine dependence prior to quitting (OR = 2.40, P = 0.001) and to have used medication in the past (OR = 3.29, P < 0.001).

Conclusions: The introduction of varenicline in the United States coincided with a net increase in attempts to quit smoking and, among these, a net increase in use of stop-smoking medications. The demographic profile of varenicline users is similar to the profile of those who use other stop-smoking medications and different from the profile of those who attempt to quit without any medication.

Keywords: Bupropion; cessation; nicotine replacement therapy; stop-smoking medication; trends; varenicline.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Cross-Sectional Studies
  • Drug Approval
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nicotinic Agonists / therapeutic use*
  • Prospective Studies
  • Smoking / epidemiology
  • Smoking Cessation / statistics & numerical data*
  • Smoking Prevention
  • Socioeconomic Factors
  • Tobacco Use Cessation Devices / trends*
  • United States
  • Varenicline / therapeutic use*
  • Young Adult


  • Nicotinic Agonists
  • Varenicline