Effects of aging on the effectiveness of smoking cessation medication

// Jaqueline Scholz 1 , Paulo Caleb Junior Lima Santos 2 , Carolina Giusti Buzo 3 , Neuza Helena Moreira Lopes 3,4 , Tania Marie Ogawa Abe 1 , Patricia Viviane Gaya 1 , Humberto Pierri 3 , Clarice Amorim 5 and Alexandre Costa Pereira 2 1 Smoking Cessation Program Department, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil 2 Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil 3 Cardio Geriatric Clinical Unit, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil 4 Fleury Group, Sao Paulo, Brazil 5 Oregon State University, Corvallis, OR, USA Correspondence to: Jaqueline Scholz, email: // Paulo Caleb Junior Lima Santos, email: // Keywords : nicotine replacement therapy, varenicline, bupropion, smoking cessation, aging, Gerotarget Received : October 08, 2015 Accepted : April 08, 2016 Published : April 28, 2016 Abstract Background: Considering the pharmacokinetic and pharmacodynamic aspects of different medications, it is plausible that the age of a smoker could affect the half-life of these drugs. The aim of this study was to compare the effectiveness of smoking cessation drugs (nicotine replacement therapy, bupropion, and varenicline) used either in isolation or in combination in adults under and over 60 years of age. Methods: Data were collected from 940 Brazilian patients participating in a smoking cessation program. Participants were prescribed smoking cessation medication to be used for at least 12 weeks and were followed for 52 weeks. Results: Cessation rates were significantly different among younger and older participants who were using nicotine replacement therapy (NRT) alone. Being over 60 years of age was significantly associated with increased cessation success among those who used NRT alone (OR 2.34, 95% CI: 1.36 to 4.04, p = 0.002). The effectiveness of varenicline and bupropion were not significantly different according to age groups. Conclusion: Using age as a predictor for tailoring smoking cessation drugs might potentially lead to a more individualized prescription of smoking cessation therapy. These results should be tested in randomized controlled trials.