P1234Smoking cessation rates with varenicline and electronic cigarettes in relapsed smokers with a history of acute coronary syndrome

Abstract

Objective: Continued cigarette smoking after acute coronary syndromes (ACS) is associated with increased mortality, and smoking cessation interventions should be integrated into the post discharge support to reduce the negative effects of smoking resumption. Aim of this study is to compare the smoking cessation efficacy and safety of e-cigarettes (EC) vs varenicline among patients who continue to smoke after a ACS. Methods: 54 patients who smoked ≥10 cigarettes/day, expressing motivation to quit smoking were randomized (1:1) to a 12-week use of either i) varenicline, ii) EC (12 mg/ml nicotine). The primary end point was point prevalence smoking abstinence at 24 weeks following randomization. Point prevalence smoking abstinence was defined by self-report of complete abstinence in the 7 days before the 24 week clinic visit. All patients in both treatment arms received low-intensity counseling. Results: The mean time interval between the ACS and study entry was 6±2.7 months. There were not significant differences in severity of nicotine dependence and cigarette consumption (pack-years) between the two groups. Figure shows a higher rate of smoking abstinence at 4, 12, and 24 weeks, among patients randomized to varenicline compared to patients randomized to EC vaping. At 24 weeks, 47.3% of varenicline patients were abstinent versus 32.5% of EC (% difference 14.8%; 95% CI 3.9, 25.8%). There were no serious adverse events during the treatment period with either varenicline or EC. Conclusion: Our preliminary data indicate that patients who received varenicline had significantly higher rates of smoking abstinence compared to patients who used EC. Future studies are needed to establish safety in these patients. (Figure Presented) .