February 9, 2022 (Toronto) — Smoking-cessation drugs prescribed exclusively over the internet in a clinical trial were as safe and effective as when prescribed in a clinician’s office, according to a newly published CAMH study in the journal Drug and Alcohol Dependence.
The study, the first internet-based trial for smoking cessation using prescription medication, found that 30.3 per cent of study participants given the drug varenicline were smoke-free after 12 weeks and 19.6 per cent given the drug bupropion were no longer smoking at the end of the trial. Notably, the quit rate was substantially lower for an unassisted attempt (without aids or intervention) and hovered between 3-5 per cent.
“This study demonstrates that internet-based smoking cessation intervention using prescription pharmacotherapy is feasible and effective—as effective as what was found in in-person clinical trials,” said lead author Dr. Laurie Zawertailo, Senior Scientist, Campbell Family Mental Health Research Institute and Addictions Division at CAMH. “The study findings can be used to inform the design of future web-based randomized controlled medication trials as well as virtual treatment delivery methods for tobacco dependence.”
Currently in Ontario, patients typically see a prescriber in person for smoking cessation drugs like varenicline which is the most effective quit-smoking medication available. The authors state that expanding the use of internet-based smoking cessation treatment programs is particularly important because the rate of smoking is disproportionately higher among marginalized populations, and those in rural areas, who may have more difficulty accessing in-person clinical trials and treatment programs.
Study co-author Dr. Peter Selby, Clinician Scientist at Campbell Family Mental Health Research Institute at CAMH, says the finding that these drugs are just as effective when used in an internet-only clinical trial is significant because it is common for smoking-cessation drugs to have better success rates in a clinical trial than in a real world setting. People in clinical trials are often situated close to the academic hospital and are also more motivated. This study is more real world and was available across Ontario.