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New Medicine, Varenicline, Helped Diabetics Quit Smoking

Introduction

Tobacco smoke comprises more than 70 known carcinogens or cancer-causing chemical substances such as tar, carbon monoxide, oxidizing chemicals, metals, and radioactive compounds. Smoking could adversely affect several organs and systems of the human body.

Besides cancers of almost every organ of the body, smoking can decrease lung)function and increase the risk of pulmonary infections and associated tissue damage. The effects of smoking on cardiovascular symptoms include hypertension (high blood pressure), increased heart rate (tachycardia), reduced body temperature, lower oxygen carrying capacity of blood cells during exercise, reduced blood flow to extremities, and increased risk of heart attacks and stroke.

Smoking lowers the antioxidant levels and increases the body’s susceptibility to infections. Other adverse effects of smoking include osteoporosis, reduced sperm counts, reduced fertility, menstrual irregularities, periodontitis (gum disease), stomach and intestinal inflammation, and premature wrinkling of the skin. In America, the Center for Disease Control and Prevention (CDC) has reported that smoking is the most common “preventable cause of death”. The adverse effects of smoking may not manifest immediately but the damage and complications can last for several years.

The good news is that quitting smoking can reverse many adverse effects of smoking. However, nicotine in smoke reaches the human brain in a few seconds and makes one feel more energized temporarily, and after the effect wears off, one feels tired and craves it more. Therefore, people find smoking difficult to quit. Studies report that effective interventions for smoking cessation among diabetic patients are limited.

About the study

A recent randomized clinical trial (RCT) published in JAMA Network was conducted to assess the efficacy of varenicline for smoking cessation among type 2 diabetes patients.

The double-blinded, placebo-controlled, and multicenter study comprised 300 smokers with type 2 diabetes, and the study findings demonstrated that varenicline was effective at week 12, week 24, and week 52 of the study in comparison to a placebo drug. Increased frequencies of nausea, abnormal dreams, insomnia, irritability, and anxiety were observed among the study participants who received varenicline compared to the placebo; however, no treatment-related serious adverse events were reported.

Participants were recruited from six outpatient clinics of five hospitals in Catania, Italy. Patients with a history of type 2 diabetes, smoked a minimum of 10 cigarettes daily, and intended to quit smoking were included. The patients either received varenicline or a placebo drug for 12 weeks (treatment phase) and follow-up assessments were performed for 40 weeks (non-treatment phase). The primary study endpoint was the continuous abstinence rates (CARs) from week 9 to week 24.

CAR values from week 9 to week 24 were substantially greater among the varenicline-treated participants compared to the placebo group participants (24% versus 6%). In addition, CARs for week 9 to week 12 (31.3% versus 7.3%) and for week 9 to week 52 (18.7% versus 5.3%) and the seven-day point prevalence of abstinence at week 12, week 24, and week 52 were substantially greater among the varenicline-treated participants.

The most commonly reported adverse events for the varenicline group were nausea (27.3%), insomnia (19.4%) abnormal dreams (12.7%), anxiety (11.4%), and irritability (9.4%). Overall, the study findings showed that including varenicline in smoking cessation interventions and education programs could be beneficial for achieving long-lasting abstinence from smoking without any serious adverse events.

Source: 

Russo C, Walicka M, Caponnetto P, et al. Efficacy and Safety of Varenicline for Smoking Cessation in Patients With Type 2 Diabetes: A Randomized Clinical Trial. JAMA Netw Open. 2022;5(6):e2217709. doi:10.1001/jamanetworkopen.2022.17709.

Author

Pooja Toshniwal Paharia

Dr. Pooja Toshniwal Paharia is a Consultant Oral and Maxillofacial Physician and Radiologist, M.DS (Oral Medicine and Radiology) from Mumbai. She strongly believes in evidence-based radiodiagnosis and therapeutic regimens for benign, potentially malignant, or malignant lesions and conditions either arising from the oral and maxillofacial structures or manifesting in the associated regions.

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