Clinical utility of varenicline for smokers with medical and psychiatric comorbidity

Jon O Ebbert, Kirk D Wyatt, Ali Zirakzadeh, Michael V Burke, JT Hays

Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA

Abstract: Chronic obstructive pulmonary disease (COPD) is a costly and deadly disease afflicting an estimated 210 million people and accounting for 5% of all global deaths. Exposure to cigarette smoke is the greatest risk factor for COPD in the developed world. Smoking cessation improves respiratory symptoms and lung function and reduces mortality among patients with COPD. Cigarette smokers with COPD and other co-morbid conditions such as cardiovascular disease and psychiatric illnesses should receive comprehensive tobacco treatment interventions incorporating efficacious pharmacotherapies. Varenicline, an α₄β₂ nicotinic acetylcholine receptor partial agonist, is the newest and most effective drug currently available to promote smoking cessation. In conjunction with behavioral interventions and clinical monitoring for potential side effects, varenicline offers great hope for reducing smoking-attributable death and disability.

Keywords: smoking cessation, chronic obstructive pulmonary disease, varenicline