Finding best way to kick the habit could depend on how smokers process nicotine

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    (Photo via ShutterStock)

    A new study suggests that knowing how your body reacts to nicotine may help you find a more effective way to kick the habit.

    Nicotine is one of the addictive ingredients in tobacco that keeps smokers lighting up.

    The investigation notes that some people break down nicotine slowly — while others process the chemical faster.

    That difference may become a biomarker — a way to personalize help for smoker, said study leader Caryn Lerman, a professor of psychiatry at the University of Pennsylvania.

    The biomarker test costs about $50, she said.

    The researchers found that “normal” nicotine metabolizers were more likely to stay off cigarettes using the medicine varenicline. In comparison to nicotine patches, some people may be genetically programmed to respond better to those pills, which are sold under the brand name Chantix, according to the study authors.

    “It would be best for smokers to choose the optimal treatment approach the first time they try to quit because, each time a smoker attempts to quit and fails, it affects their confidence in quitting and can affect their motivation in quitting,” Lerman said.

    Patches and pills were similarly effective in helping “slow” metabolizers, the study found, but Lerman said the side effects associated with the pills and the higher cost might steer doctors to recommend the nicotine patch for slow metabolizers.

    In the study of 1,246 people, about one in three people were slower metabolizers of nicotine.

    “It suggests that the patch may not be effective for as many as two-thirds of smokers, and that’s an important consideration for providers who want to increase smoking-cessation success for their patients,” Lerman said.

    GlaxoSmithKline, which markets patches under the brand name NicoDerm, emailed a statement in response to a request for comment. In part, the statement said: “We have been assisting consumers in becoming quitters for life for almost 20 years through our reputable nicotine replacement therapy (NRT) products and have helped millions fight the battle against smoking. Data from 117 clinical trials involving more than 50,000 smokers have established a long-term safety and efficacy profile for NRT.”

    Doctors have known for some time that people have widely varying success with quit-smoking medicines.

    “Studies suggest that overall success rates on the nicotine patch may vary roughly from about 15 percent to 30 percent, depending on the intensity of counseling or other therapies that are offered,” Lerman said. “For Chantix, the quit rates across the study range from about 40 percent to 50 percent.”

    “I think this study contributes to a growing understanding that nicotine addiction manifests differently in different people. And from a treatment perspective, the more we can tailor treatment, the more we can help people quit,” said Ryan Coffman, tobacco policy and control program manager with the Philadelphia Department of Public Health.

    Philadelphia links smokers to free quit-smoking medicines and counseling through the 1-800-QUIT-NOW hotline.

    People in the Medicaid program can get medications through the health plan.

    “There is coverage for nearly all the medications to help, including the patches, gum and lozenges, but also medications like Chantix, for instance,” Coffman said.

    The city also trains providers to discuss quit options with patients.

    The study, published online in Lancet Respiratory Medicine, was sponsored by the National Institutes of Health. Drugmaker Pfizer supplied the Chantix used in the study as well as placebo pills.

    “This study included a large number of investigators around the country and in Canada, and some of the co-authors have consulted for pharmaceutical companies that make smoking-cessation medicines, including Pfizer,” Lerman said.

    In an emailed statement, Pfizer said, “varenicline clinical trials conducted by Pfizer included smokers regardless of their nicotine metabolite ratio.”

    “It is important that patients discuss available treatment options with their health care providers to determine which treatment option is best for them,” continued the statement.

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