December 18, 2013
Only Minor CV Risks Associated With
Smoking-Cessation Therapies

Stanford, CA—As if quitting smoking wasn’t stressful enough, questions have been raised recently about whether smoking-cessation treatments increase cardiovascular risks. New research should help put those concerns to rest.

A study published in the American Heart Association journal Circulation finds that three major types of smoking-cessation therapies don't increase the risk of heart attack, stroke, or heart-related death.

In the large analysis of side effects, which reviewed 63 clinical trials involving 30,508 patients, serious heart events didn't increase with nicotine-replacement gums and patches or the nicotine-addiction treatment varenicline, marketed as Chantix. The antidepressant bupropion (Wellbutrin), also used to help smokers quit, actually showed some protective effect against serious heart events, according to the researchers.

“Undoubtedly, the benefits of quitting smoking outweigh any potential risks from smoking cessation therapies,” said lead author Edward J. Mills, PhD, MSc, associate professor of medicine at Stanford University and Canada Research Chair at the University of Ottawa.

Overall, smoking cessation is associated with improved cardiovascular health, increased life expectancy, improved quality of life, and reduced healthcare costs for smoking-associated conditions, according to the study.

The study uncovered some risks of minor heart symptoms, such as rapid or irregular heartbeat, with nicotine replacement therapy delivered via patch or gum but suggested the benefits of stopping smoking outweighed them.

“These more minor risks are well known to clinicians and usually pass with time,” Mills said. “They occur most often when people are taking nicotine replacement therapy and smoking at the same time, which is a bad idea.”

Previous research found that combination nicotine-replacement therapy—wearing a patch and using nicotine gum when there is the urge to smoke—may be more effective but lead to more side effects than the gum or patch alone.

Study authors cautioned that most of the patients in the research studied were relatively healthy and that the results might not apply to those with more comorbidities.

“It's possible that the risk factors might be different in people with multiple diseases,” Mills said. “Patients should discuss with their healthcare provider any potential risk factors that they may have developed from their smoking history. For patients who have chronic lung disease or other associated cardiovascular risks, clinicians should determine which smoking cessation aid to use by their risk profiles.”

U.S. Pharmacist Social Connect