Get Quit, Stay Quit! Smoking Cessation After Initial Treatment Failure

Authors:
Elizabeth Yett, PharmD, BCACP, TTS
Katherine Montag Schafer, PharmD, BCACP, CDCES

Reviewers:
Bradley Newell, PharmD, BCACP, BCGP, BC-ADM
Jean Moon, PharmD, BCACP
Jenna Knutson, PharmD


Citation:
Cinciripini PM, Green CE, Shete S, et al. Smoking Cessation After Initial Treatment Failure With Varenicline or Nicotine Replacement: A Randomized Clinical Trial. JAMA. 2024;331(20):1722–1731. 

The Problem

Smoking is one of the largest modifiable risk factors that contribute to mortality in the United States.¹ “Staying quit” reduces the prevalence of many tobacco-related cancers and chronic diseases like cardiovascular disease and chronic obstructive pulmonary disease – just to name a few. Yet, it is still difficult for patients to quit despite their best efforts. Of the nearly 70% of current smokers who want to quit smoking, only about 7.5% succeed.  This may not be surprising given that less than 5% receive recommended evidence-based counseling and pharmacotherapy.^2-3 Moreover, many patients make multiple quit attempts (average about six) before they achieve long-term success.⁴ Unfortunately, there is a lack of evidence to inform subsequent treatment strategies if the initial quit attempt is unsuccessful.