Journal
NICOTINE & TOBACCO RESEARCH
Volume 22, Issue 1, Pages 48-57Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ntr/ntz072
Keywords
-
Funding
- Global Research Awards for Nicotine Dependence (GRAND)
- National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme [14/49/94]
- Cancer Research UK Population Researcher Postdoctoral Fellowship award [C56067/A21330]
- National Institute for Health Research (NIHR) [PDF-2017-10-068]
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West
- Medical Research Council [MR/N01006X/1]
- University of Bristol [MC_UU_12013/6, MC_UU_12013/9]
- NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol
- Medical Research Council
- Pfizer
- MRC [MC_UU_00011/7, MR/N01006X/1] Funding Source: UKRI
Ask authors/readers for more resources
Objective: We conducted a prospective cohort study of the Clinical Practice Research Database to estimate rates of varenicline and nicotine replacement therapy (NRT) prescribing and the relative effects on smoking cessation, and mental health. Methods: We used multivariable logistic regression, propensity score matched regression, and instrumental variable analysis. Exposure was varenicline or NRT prescription. Mental disorders were bipolar, depression, neurotic disorder, schizophrenia, or prescriptions of antidepressants, antipsychotics, hypnotics/anxiolytics, mood stabilizers. Outcomes were smoking cessation, and incidence of neurotic disorder, depression, prescription of antidepressants, or hypnotics/anxiolytics. Follow-ups were 3, 6, and 9 months, and at 1, 2, and 4 years. Results: In all patients, NRT and varenicline prescribing declined during the study period. Seventy-eight thousand four hundred fifty-seven smokers with mental disorders aged >= 18 years were prescribed NRT (N = 59 340) or varenicline (N = 19 117) from September 1, 2006 to December 31, 2015. Compared with smokers without mental disorders, smokers with mental disorders had 31% (95% CI: 29% to 33%) lower odds of being prescribed varenicline relative to NRT, but had 19% (95% CI: 15% to 24%) greater odds of quitting at 2 years when prescribed varenicline relative to NRT. Overall, varenicline was associated with decreased or similar odds of worse mental health outcomes than NRT in patients both with and without mental disorders, although there was some variation when analyses were stratified by mental disorder subgroup. Conclusions: Smoking cessation medication prescribing may be declining in primary care. Varenicline was more effective than NRT for smoking cessation in patients with mental disorders and there is not clear consistent evidence that varenicline is adversely associated with poorer mental health outcomes.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available