About the Blog Author-John R. Hughes, MD
John R. Hughes, MD is Professor of Psychiatry, Psychology and Family Practice at the University of Vermont. Dr. Hughes is board certified in Psychiatry and Addiction Psychiatry. His major focus has been clinical research on tobacco use. Dr. Hughes received the Ove Ferno Award for research in nicotine dependence and the Alton Ochsner Award Relating Smoking and Health. He is a co-founder and past president of the Society for Research on Nicotine and Tobacco, and the Association for the Treatment of Tobacco Use and Dependence. Dr. Hughes has been Chair of the Vermont Tobacco Evaluation and Review Board which oversees VT’s multi-million dollar tobacco control programs. He has over 400 publications on nicotine and other drug dependencies and is one of the world’s most cited tobacco scientist. Dr. Hughes has been a consultant on tobacco policy to the World Health Organization, the U.S. Food and Drug Administration, and the White House. His current research is on how tobacco users and marijuana users stop or reduce use on their own, novel methods to prompt quit attempts by such users, whether smoking cessation reduces reward sensitivity and whether stopping e-cigarettes causes withdrawal. Dr Hughes has received fees from companies who develop smoking cessation devices, medications and services, from governmental and academic institutions, and from public and private organizations that promote tobacco control.
Recently three randomized, placebo-controlled trials have tested whether adding NRT to varenicline increases quit rates. The rationale for adding NRT to varencline typically involves hypothesizing a) varenicline does not bind to all nicotine receptors leaving some to be influenced by adding NRT, b) some smokers who do not respond fully to varenicline will be helped by NRT, or c) NRT is better at relieving initial withdrawal than varenicline. An alternate hypothesis is....
My ATTUD blog in April (“Is Varenicline More Effective than NRT?” - now on ATTUD website) concluded that varenicline was probably more effective than single NRT but whether it was better than dual NRT was unclear. Since then a new study and a new meta-analysis on this question have appeared that you may have heard about.
The study was a non-randomized study (Kralikova et al, Addiction, preprint available ...