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Comment & Response |

Varenicline for Smoking Reduction Prior to Cessation

Karen L. Cropsey, PsyD1; C. Brendan Clark, PhD1; Peter S. Hendricks, PhD2
[+] Author Affiliations
1Department of Psychiatry, University of Alabama, Birmingham
2School of Public Health, University of Alabama, Birmingham
JAMA. 2015;313(22):2284-2285. doi:10.1001/jama.2015.4972.
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To the Editor Dr Ebbert and colleagues1 tested the efficacy of varenicline for cessation among those willing to reduce but not quit smoking. They noted abstinence rates for the primary efficacy end point of 32.1% for the varenicline group vs 6.9% for the placebo group, with expired breath carbon monoxide levels of 10 ppm or less indicating abstinence.

However, using a carbon monoxide cutoff of 8 to 10 ppm or less, the traditional standard, may artificially inflate abstinence rates. Raiff et al2 noted that a carbon monoxide level of 3 to 4 ppm or less is the most appropriate cutoff for determining abstinence.


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June 9, 2015
Jon O. Ebbert, MD; John R. Hughes, MD; Robert J. West, PhD
1Mayo Clinic, Rochester, Minnesota
2Department of Psychiatry, University of Vermont, Burlington
3Health Behaviour Research Centre, University College London, London, England
JAMA. 2015;313(22):2285-2286. doi:10.1001/jama.2015.4981.
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