TY - JOUR T1 - Varenicline for 4 weeks prior to target quit date reduces prequit date smoking and increases 12-week abstinence JF - Evidence Based Medicine JO - Evid Based Med SP - 96 LP - 97 DO - 10.1136/ebmed.2011.100147 VL - 17 IS - 3 AU - Gina Daubney Garrison Y1 - 2012/06/01 UR - http://ebm.bmj.com/content/17/3/96.abstract N2 - Commentary on: Hajek P, McRobbie HJ, Myers KE, et al. Use of varenicline for 4 weeks before quitting smoking: decrease in ad lib smoking and increase in smoking cessation rates. Arch Intern Med 2011;171:770–7.OpenUrlCrossRefPubMedWeb of Science 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 … ER -