Varencline: More Effective For Smoking Cessation in Adults With Mental Illness When Compared to Nicotine Replacement Therapy

Lateef Ajanaku-makun
Fairleigh Dickinson University, Teaneck, NJ 07666
April 2015.

Abstract

Method contd

Results

The current first-line treatment for

smoking cessation is nicotine
replacement therapy (NRT), however
there are recent studies on varenicline
that supports varenicline as a first-line
treatment for smoking cessation. The
results of this study supported
varenicline as a first-line treatment for
smoking cessation in adults with mental
illness.

3. Critically analyze evidence: This study used the

rating system for the hierarchy of evidence for
intervention/treatment question.
4. Practice Design: There were two groups and each
had 15 participants. People in group one were
treated with NRT and people in group 2 were treated
with varenicline. After three months, the pilot test
ended and the results were analyzed.
5. Implement and evaluate change in practice:
Feedback from employess on pilot test plan indicated
that there was no need to make amendments to the
plan.
6. Integrate and maintain change in practice:
Result of the pilot study was presented to
stakeholders. Stakeholders approved a policy change
and EBP team was instructed to monitor the effects
of varenicline every three months for a year before
introducing it to surrounding clinics.

The data showed that 3 out of the

15 (20%) participants in the NRT
group was able to quit smoking,
while 8 out of the 15 (53%) of the
participants in the varenicline group
was able to quit smoking.
None of the participants reported a
drastic change in mood, worsening
symptoms of psychological
disorder, or development of new
symptoms of a psychological
disorder.
It is important to note that the
sample size for the pilot test is
small therefore the results cannot
be generalized.

Purpose
Cigarette smoking causes more
than 480,000 deaths each year in
the United States, about one in five
deaths (CDC, 2014)
Adults with mental illness are more
likely to start smoking and less
likely to quit (Glasheen, Hedden,
Forman-Hoffman, & Colpe, 2014).
The purpose of this study is to
compare the effectiveness of
varenicline and nicotine
replacement therapy (NRT) on
smoking cessation, amongst
American Adults with mental illness
within a three-month period.

Conclusion

The results from this small-scale

pilot study along with results from
peer reviewed articles, support that
varenicline is a more effective
treatment than NRT for adults with
mental illness who want to quit
smoking.
Future research should be done on
a larger scale to determine the
effectiveness and safety of
varenicline on helping adult
smokers with mental illness quit.

Reference
Method

The Model for Evidence-Based Practice

Change is used as a guideline for the
study, all six steps of the model was
followed (Melynk & Fineout-Overholt,
(2011).
1. Assess the need for change in
practice: The smoking cessation
rate at clinic was approximately
25%, which is not as high as they
would like.
2. Locate the best evidence: 10
peer reviewed research articles
were utilized as supporting
evidence for this study.

Model of evidence-based practice change (Larrabee, L.

H., [2009]. Nurse to nurse: Evidence-based practice.
New York: McGraw-Hill.

Center of Disease Control and Prevention (2014,

February 6). Health Effects of Cigarette
Smoking. Retrieved from
http://www.cdc.gov/tobacco/data_statistics/fact_
sheets/health_effects/effects_cig_smoking/inde
x.htm
Glasheen, C., Forman-Hoffman, V., Hedden, S.,
& Colpe, L. (2014). Cigarette smoking
behaviors among adults with serious mental
illness in a nationally representative sample.
Annals Of Epidemiology,
doi:10.1016/j.annepidem.2014.07.009
Stapleton, J. A., Watson, L., Spirling, L. I., Smith,
R., Milbrandt, A., Ratcliffe, M., & Sutherland, G.
(2008). Varenicline in the routine treatment of
tobacco dependence: a prepost comparison
with nicotine replacement therapy and an
evaluation in those with mental illness.
Addiction, 103(1), 146-154. doi:10.1111/j.13600443.2007.02083.x