Context

Efficacy of varenicline for tobacco cessation has been attributed to its partial agonist activity at selective nicotinic acetylcholine receptors.1 This mechanism of action is thought to reduce withdrawal symptoms, while competitively occupying receptors linked to reward pathways to decrease smoking enjoyment and intake.1 2 When combined with counselling, varenicline can improve smoking abstinence rates two to threefold.3 4

Most clinical trials of varenicline initiated therapy 1 week prior to target quit date (TQD).3 4 5 In a ‘proof-of-principle’ study, Hajek et al compared varenicline 1 week versus …