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Varenicline’s effects on acute smoking behavior and reward and their association with subsequent abstinence

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Abstract

Rationale

Varenicline may aid smoking cessation by attenuating smoking behavior and reward. We compared the effects of varenicline versus placebo on smoking behavior and reward, assessed both prospectively and retrospectively, and related these effects to subsequent success in a brief simulated quit attempt with medication.

Materials and methods

Smokers (n = 124) with high or low interest in quitting smoking participated in a double-blind crossover study of varenicline versus placebo effects on smoking behavior and reward. In each of two phases, subjects received a week of medication run-up with varenicline (0.5 mg, b.i.d.) or placebo while continuing to smoke, followed the next week by an attempt to quit while on medication. At the end of each run-up week, subjects completed retrospective measures of smoking reward (liking) and number of cigarettes over the prior 24 hrs, and they provided an expired air carbon monoxide (CO) measure. They then completed a prospective session in which they ad lib smoked and rated the rewarding effects of one of their preferred cigarettes while blind to brand.

Results

Varenicline decreased smoking reward significantly in the prospective assessment, but only marginally in the retrospective assessment. Varenicline did not alter smoking behavior prospectively, but did reduce CO and retrospective report of smoking amount. None of these effects of varenicline predicted subsequent days of abstinence due to varenicline.

Conclusions

During medication run-up, varenicline decreases acute smoking reward and may attenuate smoking behavior, but these effects do not appear to directly predict varenicline’s influence on smoking abstinence in a short-term test.

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Acknowledgments

This research was supported by NIH Grant P50 CA143187. The authors thank Pfizer for providing varenicline and matching placebo for this study and John S. Slifka, Zachary Chakan, Roy Chengappa MD, and Abishek Jain MD for their valuable assistance.

Conflict of interest

K Perkins has served as a consultant for GlaxoSmithKline.

C Lerman has served as a consultant or has received research funding from GlaxoSmithKline, Pfizer, Novartis, and AstraZeneca. Research support received was unrelated to the current study.

No other authors have any potential conflicts of interest to report.

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Authors and Affiliations

  1. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA

    Kenneth A. Perkins, Melissa Mercincavage & Carolyn A. Fonte

  2. Department of Psychiatry and Annenberg Public Policy Center, Abramson Cancer Center of the University of Pennsylvania, 3535 Market Street–Suite 4100, Philadelphia, PA, 19104, USA

    Caryn Lerman

  3. WPIC, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA, 15213, USA

    Kenneth A. Perkins, Melissa Mercincavage & Carolyn A. Fonte

Authors
  1. Kenneth A. Perkins
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  2. Melissa Mercincavage
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  3. Carolyn A. Fonte
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  4. Caryn Lerman
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Corresponding author

Correspondence to Kenneth A. Perkins.

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Perkins, K.A., Mercincavage, M., Fonte, C.A. et al. Varenicline’s effects on acute smoking behavior and reward and their association with subsequent abstinence. Psychopharmacology 210, 45–51 (2010). https://doi.org/10.1007/s00213-010-1816-9

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  • DOI: https://doi.org/10.1007/s00213-010-1816-9

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