How to Quit the Smoking Habit: Smokers that Combine Multiple Treatments Have More Success

Want to kick the smoking habit? Then combining multiple treatments may help. Researchers have found that using two smoking cessation therapies is far more effective than using just one for male and high nicotine-dependent smokers who were not initially helped by the patch.

Smoking cessation treatments, including nicotine replacement, bupropion and varenicline, have modest long-term success rates. In fact, less than 25 percent of smokers continue to kick the habit a year after treatment.

"It's clear that we need to improve success rates for smoking cessation, and it is thought that combining treatments could add to the efficacy," said Jed Rose, one of the researchers, in a news release. "Combining two therapies, especially if they act by different mechanisms, may address different aspects of the addiction."

In order to examine the benefit of combining treatments, the researchers examined 349 adults who reported smoking about 10 or more cigarettes per day. Prior to quitting, all participants were given nicotine patches. After about a week on the patch, the 222 volunteers who did not cut their smoking by 50 percent were then randomly assigned to either take varenicline and a placebo, or a combination of varenicline and bupropion.

What did they find? It turns out that there was an overall benefit of adding bupropion to varenicline. In fact, 39.8 percent of participants on the combination treatment abstained from smoking at weeks 8 to 11 after the target quite date, versus the 25.9 percent taking varenicline alone.

"Highly dependent male smokers had a boost in quit rates from 14 percent on varenicline alone to 61 percent with the combination treatment, which is a dramatic increase," said Rose in a news release. "While there may be some drawbacks to prescribing two smoking cessation treatments, such as cost or possible side effects, this study gives us a simple strategy to find those who would benefit the most from combined treatment, and spare others who may not benefit."

The findings are published in the American Journal of Psychiatry.