Effectiveness and safety of varenicline and nicotine replacement therapy among mental health patients: A retrospective cohort study

Abstract Objective To analyse the effectiveness and safety of two smoking cessation medications (varenicline and nicotine patches) in patients with controlled psychiatric disorders in daily practice in a Smoking Cessation Service. Methods This is a retrospective cohort study. It was carried on at a smoking cessation clinic in Madrid and used a convenience sampling strategy. We reviewed medical records of patients diagnosed with psychiatric disorders who attended a Smoking Cessation Service. All patients received similar treatment programme: a combination of pharmacological treatment (varenicline or nicotine replacement therapy) and intensive cognitive-behavioural therapy. Results The group included 349 patients (38.4% men). Mean age (SD) 49.6 (10.5) years. 28.3 (12.8) cigarettes per day. 156 subjects achieved 9–24 weeks continuous abstinence (44.7%), in 39% of those who used nicotine patches and in 53.7% of those who used varenicline. OR: 1.64 (95% CI: 1.03–2.61; p  = 0.036). Success rates were higher in men; OR 1.85 (95% CI: 1.12–3.04; p  = 0.016). High levels of CO and high daily cigarette use were associated with poorer success rates (OR: 0.98, 95% CI: 0.96–0.99, p  = 0.007; and OR: 0.98, 95% CI: 0.96–1.00, p  = 0.045), respectively. Nausea and pruritus were the most common adverse events. No cases of suicidal ideation or behaviour were found. Conclusions Varenicline and nicotine patches could be safe and effective smoking cessation treatments for patients with psychiatric disorders in daily clinical practice.