{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:07:26Z","timestamp":1793138846820,"version":"4.5.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T00:00:00Z","timestamp":1562716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cancer Research UK Population Researcher Postdoctoral Fellowship","award":["C56067\/A21330"],"award-info":[{"award-number":["C56067\/A21330"]}]},{"name":"Global Research Awards for Nicotine Dependence"},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/N01006X\/1"],"award-info":[{"award-number":["MR\/N01006X\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000883","name":"University of Bristol","doi-asserted-by":"publisher","award":["MC_UU_12013\/6"],"award-info":[{"award-number":["MC_UU_12013\/6"]}],"id":[{"id":"10.13039\/501100000883","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000883","name":"University of Bristol","doi-asserted-by":"publisher","award":["MC_UU_12013\/9"],"award-info":[{"award-number":["MC_UU_12013\/9"]}],"id":[{"id":"10.13039\/501100000883","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We conducted a prospective cohort study of the Clinical Practice Research Database to estimate rates of varenicline and nicotine replacement therapy (NRT) prescribing and the relative effects on smoking cessation, and mental health.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used multivariable logistic regression, propensity score matched regression, and instrumental variable analysis. Exposure was varenicline or NRT prescription. Mental disorders were bipolar, depression, neurotic disorder, schizophrenia, or prescriptions of antidepressants, antipsychotics, hypnotics\/anxiolytics, mood stabilizers. Outcomes were smoking cessation, and incidence of neurotic disorder, depression, prescription of antidepressants, or hypnotics\/anxiolytics. Follow-ups were 3, 6, and 9 months, and at 1, 2, and 4 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In all patients, NRT and varenicline prescribing declined during the study period. Seventy-eight thousand four hundred fifty-seven smokers with mental disorders aged \u226518 years were prescribed NRT (N = 59 340) or varenicline (N = 19 117) from September 1, 2006 to December 31, 2015. Compared with smokers without mental disorders, smokers with mental disorders had 31% (95% CI: 29% to 33%) lower odds of being prescribed varenicline relative to NRT, but had 19% (95% CI: 15% to 24%) greater odds of quitting at 2 years when prescribed varenicline relative to NRT. Overall, varenicline was associated with decreased or similar odds of worse mental health outcomes than NRT in patients both with and without mental disorders, although there was some variation when analyses were stratified by mental disorder subgroup.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Smoking cessation medication prescribing may be declining in primary care. Varenicline was more effective than NRT for smoking cessation in patients with mental disorders and there is not clear consistent evidence that varenicline is adversely associated with poorer mental health outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>Patients with mental disorders were less likely to be prescribed varenicline than NRT. We triangulated results from three analytical techniques. We found that varenicline was more effective than NRT for smoking cessation in patients with mental disorders. Varenicline was generally associated with similar or decreased odds of poorer mental health outcomes (ie, improvements in mental health) when compared with NRT. We report these findings cautiously as our data are observational and are at risk of confounding.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntz072","type":"journal-article","created":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T19:12:02Z","timestamp":1556737922000},"page":"48-57","source":"Crossref","is-referenced-by-count":68,"title":["Prescribing Prevalence, Effectiveness, and Mental Health Safety of Smoking Cessation Medicines in Patients With Mental Disorders"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2185-0162","authenticated-orcid":false,"given":"Gemma M J","family":"Taylor","sequence":"first","affiliation":[{"name":"Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK"},{"name":"UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK"},{"name":"Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha","family":"Itani","sequence":"first","affiliation":[{"name":"Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK"},{"name":"UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyla H","family":"Thomas","sequence":"first","affiliation":[{"name":"Bristol Medical School, Population Health Sciences, Canynge Hall, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dheeraj","family":"Rai","sequence":"first","affiliation":[{"name":"Centre for Academic Mental Health; Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Jones","sequence":"first","affiliation":[{"name":"National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Windmeijer","sequence":"first","affiliation":[{"name":"Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK"},{"name":"Department of Economics, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7992-7719","authenticated-orcid":false,"given":"Richard M","family":"Martin","sequence":"first","affiliation":[{"name":"Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK"},{"name":"Bristol Medical School, Population Health Sciences, Canynge Hall, University of Bristol, Bristol, UK"},{"name":"NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4049-993X","authenticated-orcid":false,"given":"Marcus R","family":"Munaf\u00f2","sequence":"first","affiliation":[{"name":"Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK"},{"name":"UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil M","family":"Davies","sequence":"first","affiliation":[{"name":"Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK"},{"name":"Bristol Medical School, Population Health Sciences, Canynge Hall, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy E","family":"Taylor","sequence":"first","affiliation":[{"name":"Bristol Medical School, Population Health Sciences, Canynge Hall, University of Bristol, Bristol, UK"},{"name":"NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,7,10]]},"reference":[{"key":"2020031606073611200_CIT0001","volume-title":"WHO Report on the Global Tobacco Epidemic: Warning about the Dangers of Tobacco","author":"World Health Organisation","year":"2011"},{"issue":"9","key":"2020031606073611200_CIT0002","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1038\/nrc2703","article-title":"Avoidable global cancer deaths and total deaths from smoking","volume":"9","author":"Jha","year":"2009","journal-title":"Nat Rev Cancer."},{"key":"2020031606073611200_CIT0003","author":"Office for National Statistics","year":"2016"},{"key":"2020031606073611200_CIT0004","volume-title":"Smoking and Mental Health","author":"Royal College of Physicians; 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