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Quit Smoking? Blood Markers can Tell if You Should Use Patch or Pill

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Quitting smoking habits is not easy with about 70 percent of those who attempt to quit relapse in as little as one week but it appears that assessing how the bodies of smokers breakdown nicotine could improve the odds of anyone who want to quit the unhealthy habit.

Nicotine is a highly addictive substance found in cigarettes that smokers crave for when levels in their body drop, giving rise to urges to smoke again but the rate of breaking down this substance vary among different individuals.

Some researchers suggest that those who break down nicotine faster tend to crave more cigarettes making it hard for them to quit and now in a new randomized trial, a group of researchers found that the best treatment for individual smokers depend on how quickly nicotine is metabolized in their body.

For the study, which was published in the journal Lancet Respiratory Medicine on Jan. 12, Rachel Tyndale, from the Centre for Addiction and Mental Health in Toronto, Canada, and colleagues compared the quit rate of 1,246 smokers who all received behavioral counseling and were either placed on nicotine replacement patch or given Champix (varenicline), a smoking cessation drug.

The researchers looked at the participants' blood to determine if nicotine was broken down at a slow or normal rate using a biomarker known as nicotine metabolite ratio (NMR), which revealed that 662 of the participants were slow metabolizers and the rest were normal metabolizers.

Tyndale and colleagues found that the normal metabolizers had increased odds of staying off of smoking after taking the smoking cessation drug compared with those who used patch.

By the end of the 11th week and after a six month follow-up period, nearly 39 percent of those taking varenicline were not smoking, which is significantly higher compared with 23 percent rate in those who used patch.

The result of the study suggests that varenicline is a more effective smoking cessation treatment for normal metabolizers albeit the efficacy is the almost same for the slow metabolizers with 28 percent quit rates in smokers who used patch and 30 percent in those who took the pill.

Slow metabolizers, however, experienced more side effects using varenicline and this suggests they can gain more benefit when using patch.

"Our data suggest that treating normal metabolizers with varenicline, and slow metabolizers with the nicotine patch could provide a practical clinical approach," the researchers wrote.

No NMR test is currently commercially available outside of hospitals and research laboratories but the U.S. National Institute on Drug Abuse has given funding for the development of a test kit for doctors.

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