A randomized trial published in JAMA Network Open has found that participants who received adaptive treatment had higher smoking abstinence rates compared to those who received nonadaptive treatment. Adaptive treatment, also known as adaptive pharmacotherapy, involves modifying a patient’s medication regimen based on their response to the initial medication. While adaptive treatment is a common medical practice, its use for smoking cessation has not been widespread.
The researchers conducted a randomized clinical trial to determine whether adaptive pharmacotherapy leads to higher smoking abstinence rates than standard pharmacotherapy in a clinical practice setting. The study included 188 daily smokers aged 18 years or older who were willing to attempt smoking cessation. The participants were allowed to choose between varenicline or nicotine patches before being randomly assigned to either adaptive or standard treatment.
Participants in the adaptive treatment group who did not reduce their daily cigarette consumption by at least 50% received bupropion in addition to their chosen medication. On the other hand, responders in the adaptive treatment group, as well as all participants in the standard treatment group, received placebo bupropion. At the end of the study, the researchers observed higher rates of biochemically verified 30-day continuous smoking abstinence in the adaptive treatment group compared to the standard treatment group.
The findings of this study suggest that adaptive treatment is effective for smoking cessation. The use of precessation varenicline and nicotine patches in an adaptive treatment regimen, with bupropion provided to treat nonresponders, showed promising results. However, the study had some limitations, including the exclusion of certain racial and ethnic groups, which limits the generalizability of the findings to these populations.
In conclusion, this study adds to the growing body of literature on adaptive treatment for smoking cessation. It provides evidence that adaptive pharmacotherapy can lead to higher smoking abstinence rates when compared to standard pharmacotherapy. This research highlights the importance of individualized treatment approaches in helping smokers quit.
Davis JM, Masclans L, Rose JE. Adaptive smoking cessation using precessation varenicline or nicotine patch: a randomized clinical trial. JAMA Netw Open. 2023;6(9):e2332214. doi:10.1001/jamanetworkopen.2023.32214.