Nicotine replacement therapy and varenicline: A cohort study in low-incomeregion (Monastir, Tunisia).

Background: Among motivated Smokers, cessation can be performed by Nicotine Replacement Therapy (NRT), or by Varenicline (VAR). We aimed at determining quit rates among two cohorts, treated by NRT or VAR and, at identifying factors associated to quit and relapse delays. Methods: We carried out a prospective cohort study at the smoking cessation center of the University Hospital of Monastir, in Tunisia from April 2009 to January 2012. Results: 1042 active smokers have been followed in smoking cessation center between April 2009 and December 2010. One hundred eighty two participants had met the inclusion criteria and had agreed to participate in our study. Abstinence rates, were, 61.5% at 3 month follow up and 36.3% at one year (p=0.01). After adjusting on age, alcohol consumption, anxiety scale, and exhaled carbon monoxide values, there were no significant differences on abstinence rates in two groups NRT or VAR. In multivariate analysis, factors associated to a precipitate smoking relapse were presence of anterior previous attempts (HR: 0.10; 95% CI: 0.030-0.328), living with smokers at home (HR: 2.541; 95% CI: 1.019-6.336), having five following visits (HR: 0.091; 95% CI: 0.017-0.500) and having minimal withdrawal syndrome reveled on follow up (HR: 0.23; 95% CI: 0.08-0.662). Whereas, factors associated to quit delay was the use of NRT at the expense of VAR (HR: 4.966; 95% CI: 2.81-8.76). Conclusions: Relapse was not associated to treatment classes, whereas NRT have the benefit of a longer quit duration.