Trying a Different Smoking Cessation Medication after Relapse Actually IMPROVES Chances of Quitting

September 27th, 2017 by Smokers' Helpline

A new article published in the August 2017 edition of the American Journal of Preventive Medicine has some positive news for smokers who relapse after a quit attempt: trying different smoking cessation medications in future quit attempts improves your chances of quitting.

Background and Methods
Relapse after attempting to quit smoking is a common occurrence, as nicotine is an extremely addictive substance. Indeed, most people require multiple quit attempts before they have long-term success in staying smoke-free. Previous research has seldom examined the quit medications that smokers use across multiple quit attempts, or determined if trying a different medication after relapse results in greater success. To address this research gap, the authors analyzed data from an international cohort study to evaluate the effectiveness of either using the same smoking cessation medications or trying different medications over multiple quit attempts.

The study population included nationally representative samples of adult smokers who participated in the International Tobacco Control Four Country Survey between 2006 and 2011 in Canada, the United States, the United Kingdom, and Australia. Survey participants who relapsed during this time period and used a different smoking cessation medication in their next quit attempt were coded as “switchers,” and those who used the same medication across two or more quit attempts were coded as “repeaters.” The term “medication” in this study includes nicotine replacement therapies (e.g. nicotine patch, nicotine gum, nicotine lozenge, nicotine tab, and other NRTs) as well as prescription pills (e.g. bupropion/Zyban and varenicline/Champix). Participants were considered abstinent (i.e. smoke-free) when they indicated that they had not smoked within the past month during a survey wave.

Results
The authors found that switchers were more than twice as likely to remain smoke-free one month after initiating a quit attempt (28.5%) when compared to repeaters (12.4%). Their findings raised the following question: why does switching to a different smoking cessation medication improve quit outcomes? To answer this question, they propose several possible explanations. First, they noticed that repeaters tended to use just one type of smoking cessation medication (e.g. patch only) across multiple attempts, while switchers tended to add an additional medication to future attempts (e.g. patch and gum); it is therefore possible that combination strategies are more effective. As well, switchers were more likely than repeaters to use prescription-only smoking cessation medications in later attempts; they would have therefore also had the advantage of interacting with a health care professional who may have provided counseling.

Interestingly, even after statistically controlling for differences in the number of quit medications used in each attempt, the authors found no evidence of one single smoking cessation tool being superior to any other. Rather, the mere “act of switching appeared to be driving better quit success, regardless of the [smoking cessation medications] that smokers were switching to/from.” This suggestion lends further support to something we’ve known for some time: what works for one person may not work for another, as everyone is different. It also places further emphasis on the importance of not giving up after a failed quit attempt, and of trying different smoking cessation strategies until you find something that works for you.

What this Study Means for You
If you’ve attempted to quit smoking and have been unsuccessful, don’t be discouraged: try switching things up a bit during your next attempt. Instead of simply trying the nicotine patch again, for instance, consider combining the patch and gum, or the patch and lozenges. Alternatively, talk to your doctor about trying out prescription-based medications like Champix or Zyban. The important thing to keep in mind is that the research shows that if you keep trying and are willing to take a different approach, you will have a better chance of finding something that works for you.

For more information about the various smoking cessation strategies that are available, feel free to give the Smokers’ Helpline a call at 1-800-363-5864 or email us at shl@nf.lung.ca. We’re happy to provide you with any support you may need and help you set up a quit plan.

If you would like to read the abovementioned study in full and have access via an academic institution like Memorial University, click here: https://www.ncbi.nlm.nih.gov/pubmed/28336353.

Reference:
Heckman, B.W., Cummings, K.M., Kasza, K.A., Borland, R., Burris, J.L., Fong, G.T., McNeill, A., & Carpenter, M.J. (2017). Effectiveness of switching smoking-cessation medications following relapse. American Journal of Preventive Medicine, 53(2), e63-e70. http://dx.doi.org/10.1016/j.amepre.2017.01.038