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Ability to Process Nicotine Linked to Efficacy of Patch vs Pill

CardioSmart News

How quickly smokers metabolize nicotine—an addictive substance found in cigarettes—may impact whether the nicotine patch or pill will succeed in helping them quit, according to a study published in The Lancet.

The nicotine patch and the pill, varenicline (brand name: Chantix), are among the most common smoking cessation aids used to help smokers quit. The nicotine patch is a form of nicotine replacement therapy that delivers a steady stream of nicotine to reduce cravings, which adults use to gradually wean themselves off the addictive substance. Varenicline on the other hand, is a pill that helps the brain block the pleasant effects of nicotine to help smokers quit.

In a recent study, researchers compared these two smoking cessation aids among individuals that process nicotine at different rates, using a genetic biomarker called the nicotine metabolite ratio. This biomarker indicates how quickly the body metabolizes or breaks down nicotine and could help impact how well a smoking cessation aid works for smokers.

A total of 1,246 individuals participated in the study, roughly half of whom were considered slow metabolizers of nicotine while the other half metabolized nicotine at a normal rate. Participants received smoking cessation counseling and were randomly assigned to one of three treatments: the nicotine patch, varenicline, or an inactive treatment containing no medicine. All treatments lasted 11 weeks and one year after the quit date, researchers followed up with participants to see how many kicked the habit for good.

Researchers found that the pill was two times more effective than the patch in participants who metabolized nicotine at a normal rate compared to those with a slower nicotine metabolism. Interestingly, slow metabolizers also experienced more side-effects from the pill than normal metabolizers.

Based on their findings, authors believe that varenicline may be more appropriate for individuals with a normal nicotine metabolism, while the patch may be more effective in those with a slow nicotine metabolism. Tailoring treatments based on nicotine metabolism could help increase quit rates among smokers and minimize side-effects from smoking cessation aids.
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