Smoking Cessation
Conditions
Keywords
smoking cessation, smoking treatment, patient self-selected quit date
Brief summary
The hypothesis is that varenicline will be effective (compared with placebo) for smoking cessation when subjects are allowed to set their own quit date within the first 5 weeks of treatment.
Interventions
placebo tablet taken orally twice daily for 12 weeks
varenicline tablets, 1 mg taken orally twice daily for 12 weeks
Sponsors
Study design
Eligibility
Inclusion criteria
* Men and women * 18 to 75 yrs old * Motivated to stop smoking * Smoke at least 10 cigarettes/day
Exclusion criteria
* Active psychiatric disease * Severe or unstable cardiovascular or pulmonary disease * Current or recent treatment to stop smoking * Previous use of varenicline
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With 4-week Continuous Abstinence (CA) | Week 9 through Week 12 | The percentage of participants who reported complete abstinence from cigarette smoking and other nicotine use (on the Nicotine Use Inventory) and who did not have carbon monoxide (CO) \>10 parts per million (ppm) at any visits Week 9 through Week 12. A participant was considered a responder if they met the following criterion: said they had not smoked or used nicotine products 'since the last visit' and did not have CO \>10 ppm. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Continuous Abstinence (CA) From Smoking Weeks 9-24 | Week 9 through Week 24 | Percentage of participants with CA from cigarette smoking and other nicotine-containing (treatment phase) or tobacco (non-treatment phase) products use, who did not have CO \>10 ppm at any visits Week 9 through Week 24. A participant was considered a responder if they met the following criterion: said they had not smoked or used nicotine products 'since the last visit' and did not have CO \>10 ppm. |
| Percentage of Participants With Long Term Quit Through Week 24 | Week 9 through Week 24 | Responder for the primary endpoint of CA from Week 9 through Week 12 and who had no more than 6 days of smoking during the non-treatment phase of the study. For Weeks 13, 16, 20, and 24, long term quit was determined by CO-confirmed in-clinic visit. |
| Percentage of Participants With 7-day Point Prevalence of Nonsmoking (Smoking Cessation) | Week 12 and Week 24 | Percentage of participants with complete abstinence from cigarette smoking or other nicotine-containing (treatment phase) or tobacco (non-treatment phase) products use for the 7 days prior to Week 12 and Week 24, respectively, who did not have CO \>10 ppm at any visits. CO-confirmed in-clinic visit. |
| Percentage of Participants With 4-week Point Prevalence of Nonsmoking | Week 24 | Percentage of participants with complete abstinence from cigarette smoking or use of tobacco products for the 4 weeks prior to Week 24 who did not have CO \>10 ppm at any visits. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Fagerström Test for Nicotine Dependence (FTND) to Day of First Quit Attempt (FQA) Through Week 5 by Smoking Status at Weeks 9-12 | Baseline through Week 5 | Change in nicotine dependence from baseline to the date of the FQA within the first 5 weeks. FTND was designed to provide an ordinal measure of nicotine dependence related to cigarette smoking. It contains items that evaluate the quantity of cigarette consumption, the compulsion to use, and dependence. The FTND contains 4 yes-no and 2 multiple choice questions and can be used in a self-report format. The items on FTND are scored 0 to 3 for multiple choice items, the items are summed to yield a total score of 0-10 (0=minimum nicotine dependence; 10=maximum nicotine dependence). |
Countries
Argentina, Brazil, Canada, China, Czechia, France, Germany, Hungary, Italy, Mexico, South Korea, Taiwan, United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Varenicline Varenicline 0.5 mg administered QD for the first 3 days followed by 0.5 mg varenicline BID for the next 4 days, then 1 mg varenicline BID for the remaining 11 weeks (treatment phase). Blinded study drug was discontinued at the Week 12 visit and was followed by a non-treatment phase to Week 24. | 486 |
| Placebo Placebo matched to varenicline. | 165 |
| Total | 651 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 14 | 6 |
| Overall Study | Lost to Follow-up | 17 | 10 |
| Overall Study | Other known cause | 6 | 1 |
| Overall Study | Randomized by not treated | 7 | 1 |
| Overall Study | Withdrawal by Subject | 24 | 7 |
Baseline characteristics
| Characteristic | Total | Placebo | Varenicline |
|---|---|---|---|
| Age, Customized >= 65 years | 37 Participants | 8 Participants | 29 Participants |
| Age, Customized Between 18 and 44 years | 341 Participants | 93 Participants | 248 Participants |
| Age, Customized Between 45 and 64 years | 273 Participants | 64 Participants | 209 Participants |
| Sex: Female, Male Female | 259 Participants | 66 Participants | 193 Participants |
| Sex: Female, Male Male | 392 Participants | 99 Participants | 293 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 297 / 486 | 79 / 165 |
| serious Total, serious adverse events | 6 / 486 | 1 / 165 |
Outcome results
Percentage of Participants With 4-week Continuous Abstinence (CA)
The percentage of participants who reported complete abstinence from cigarette smoking and other nicotine use (on the Nicotine Use Inventory) and who did not have carbon monoxide (CO) \>10 parts per million (ppm) at any visits Week 9 through Week 12. A participant was considered a responder if they met the following criterion: said they had not smoked or used nicotine products 'since the last visit' and did not have CO \>10 ppm.
Time frame: Week 9 through Week 12
Population: Full analysis set (FAS): took at least 1 dose, including partial doses, of randomized study drug. Missing CO measurements imputed as =\<10 ppm. Missing visit(s) imputed based on next available visit. Subjects who discontinued study and were lost to follow up were assumed smokers. Missing data not imputed from other weekly interview questions.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Varenicline | Percentage of Participants With 4-week Continuous Abstinence (CA) | 53.9 Percentage of participants |
| Placebo | Percentage of Participants With 4-week Continuous Abstinence (CA) | 19.4 Percentage of participants |
Percentage of Participants With 4-week Point Prevalence of Nonsmoking
Percentage of participants with complete abstinence from cigarette smoking or use of tobacco products for the 4 weeks prior to Week 24 who did not have CO \>10 ppm at any visits.
Time frame: Week 24
Population: FAS. Missing inventory interview questions of whether the subject had smoked or used any other tobacco products in the last 4 weeks were not imputed. Missing CO was imputed as =\<10 ppm.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Varenicline | Percentage of Participants With 4-week Point Prevalence of Nonsmoking | 42.0 Percentage of participants |
| Placebo | Percentage of Participants With 4-week Point Prevalence of Nonsmoking | 17.0 Percentage of participants |
Percentage of Participants With 7-day Point Prevalence of Nonsmoking (Smoking Cessation)
Percentage of participants with complete abstinence from cigarette smoking or other nicotine-containing (treatment phase) or tobacco (non-treatment phase) products use for the 7 days prior to Week 12 and Week 24, respectively, who did not have CO \>10 ppm at any visits. CO-confirmed in-clinic visit.
Time frame: Week 12 and Week 24
Population: FAS. Missing weekly interview questions of whether the subject had smoked in the last 7 days were not imputed; missing CO was imputed as =\<10 ppm.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Varenicline | Percentage of Participants With 7-day Point Prevalence of Nonsmoking (Smoking Cessation) | Week 12 | 59.5 Percentage of participants |
| Varenicline | Percentage of Participants With 7-day Point Prevalence of Nonsmoking (Smoking Cessation) | Week 24 | 43.0 Percentage of participants |
| Placebo | Percentage of Participants With 7-day Point Prevalence of Nonsmoking (Smoking Cessation) | Week 12 | 24.2 Percentage of participants |
| Placebo | Percentage of Participants With 7-day Point Prevalence of Nonsmoking (Smoking Cessation) | Week 24 | 17.6 Percentage of participants |
Percentage of Participants With Continuous Abstinence (CA) From Smoking Weeks 9-24
Percentage of participants with CA from cigarette smoking and other nicotine-containing (treatment phase) or tobacco (non-treatment phase) products use, who did not have CO \>10 ppm at any visits Week 9 through Week 24. A participant was considered a responder if they met the following criterion: said they had not smoked or used nicotine products 'since the last visit' and did not have CO \>10 ppm.
Time frame: Week 9 through Week 24
Population: FAS. Missing CO measurements imputed as =\<10 ppm. Missing visit(s) imputed based on next available visit. Subjects who discontinued study and were lost to follow up were assumed smokers. Missing data not imputed from other weekly interview questions.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Varenicline | Percentage of Participants With Continuous Abstinence (CA) From Smoking Weeks 9-24 | 35.2 Percentage of participants |
| Placebo | Percentage of Participants With Continuous Abstinence (CA) From Smoking Weeks 9-24 | 12.7 Percentage of participants |
Percentage of Participants With Long Term Quit Through Week 24
Responder for the primary endpoint of CA from Week 9 through Week 12 and who had no more than 6 days of smoking during the non-treatment phase of the study. For Weeks 13, 16, 20, and 24, long term quit was determined by CO-confirmed in-clinic visit.
Time frame: Week 9 through Week 24
Population: FAS. If the number of days smoked was missing for a subject visit, the CA responder status of the subject at that visit determined the imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Varenicline | Percentage of Participants With Long Term Quit Through Week 24 | 40.7 Percentage of participants |
| Placebo | Percentage of Participants With Long Term Quit Through Week 24 | 14.6 Percentage of participants |
Change From Baseline in Fagerström Test for Nicotine Dependence (FTND) to Day of First Quit Attempt (FQA) Through Week 5 by Smoking Status at Weeks 9-12
Change in nicotine dependence from baseline to the date of the FQA within the first 5 weeks. FTND was designed to provide an ordinal measure of nicotine dependence related to cigarette smoking. It contains items that evaluate the quantity of cigarette consumption, the compulsion to use, and dependence. The FTND contains 4 yes-no and 2 multiple choice questions and can be used in a self-report format. The items on FTND are scored 0 to 3 for multiple choice items, the items are summed to yield a total score of 0-10 (0=minimum nicotine dependence; 10=maximum nicotine dependence).
Time frame: Baseline through Week 5
Population: Number of participants analyzed = participants with FQA through Week 5, excluding 157 participants for whom FTND was not done at the time of FQA (1 participant also had inconsistent FQA date with first dosing date). Analysis done by smoking status at Week 12 (Responder for the primary endpoint of CA Weeks 9-12).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Varenicline | Change From Baseline in Fagerström Test for Nicotine Dependence (FTND) to Day of First Quit Attempt (FQA) Through Week 5 by Smoking Status at Weeks 9-12 | Responders | -2.3 Units on a scale | Standard Deviation 2.53 |
| Varenicline | Change From Baseline in Fagerström Test for Nicotine Dependence (FTND) to Day of First Quit Attempt (FQA) Through Week 5 by Smoking Status at Weeks 9-12 | Non-Responders | -2.5 Units on a scale | Standard Deviation 2.55 |
| Placebo | Change From Baseline in Fagerström Test for Nicotine Dependence (FTND) to Day of First Quit Attempt (FQA) Through Week 5 by Smoking Status at Weeks 9-12 | Responders | -1.8 Units on a scale | Standard Deviation 1.95 |
| Placebo | Change From Baseline in Fagerström Test for Nicotine Dependence (FTND) to Day of First Quit Attempt (FQA) Through Week 5 by Smoking Status at Weeks 9-12 | Non-Responders | -1.8 Units on a scale | Standard Deviation 2.13 |