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35th AM (2025) - Poster Session
Evaluating the Efficacy of Lowered Varenicline Dos ...
Evaluating the Efficacy of Lowered Varenicline Dosing after Cigarette Smoking Cessation in Cancer Patients
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This study evaluated the efficacy of a reduced maintenance dose of varenicline (1 mg/day) versus the standard dose (2 mg/day) for sustaining smoking cessation in cancer patients treated at MD Anderson Cancer Center’s Tobacco Research and Treatment Program. Smoking is a leading preventable cause of death, and varenicline is a highly effective smoking cessation medication. However, its high cost often leads to premature treatment discontinuation. The investigation aimed to assess whether lowering the dose after initial cessation could maintain long-term abstinence while reducing financial burden.<br /><br />A cohort of 4,101 adult cancer patients treated with varenicline plus behavioral counseling was reviewed, focusing on 330 patients who achieved at least one month (4 weeks) of abstinence on 2 mg/day varenicline. Of these, 32 patients had their dose reduced to 1 mg/day, while 163 remained on 2 mg/day. Abstinence was self-reported at 3 months (end of treatment, EOT), 6 months, and 9 months after initial consultation.<br /><br />Results showed no significant difference in abstinence rates between the reduced-dose and standard-dose groups at EOT (56.25% vs. 57.06%, p=1.00) and 9 months (78.57% vs. 74.19%, p=0.81). Interestingly, at 6 months, the reduced-dose group had a statistically significant higher abstinence rate (84.38% vs. 82.21%, p=0.05). Across all time points, comparable proportions remained abstinent in both groups.<br /><br />The findings suggest that a lowered maintenance dose of varenicline after initial cessation is equally effective as the standard dose in sustaining abstinence among cancer patients. This approach can reduce treatment costs and improve adherence, particularly benefiting patients facing financial or insurance constraints. The authors advocate for personalized, flexible treatment plans considering patients' social determinants of health to optimize long-term smoking cessation success in medically complex populations.
Keywords
varenicline
smoking cessation
cancer patients
maintenance dose
dose reduction
MD Anderson Cancer Center
tobacco treatment
abstinence rates
behavioral counseling
treatment adherence
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