Twelve weeks of smoking cessation therapy with varenicline increases the serum levels of apolipoprotein A-I only in the success group

BackgroundCigarette smoking adversely affects lipid profiles, and smoking cessation should improve lipid profiles in the long term. However, it remains unclear whether intensive, medication-based smoking cessation therapy can affect lipid profiles in the short term. Thus, we evaluated the short-term effects of smoking cessation therapy with varenicline on lipid profiles.MethodsParticipants included 86 consecutive subjects who received 12 weeks of smoking cessation therapy. All subjects were treated with varenicline, and no changes were made to their current lipotropic and antidiabetic medications during treatment. At first and last visits, lipid profiles and fasting blood glucose and hemoglobin A1c levels were evaluated and physical examination was performed. The success group, comprising subjects who attained exhaled carbon monoxide-confirmed 4-week continuous abstinence, included 69 subjects, whereas the failure group, comprising those who did not achieve complete smoking cessation, included 17 subjects. The number of cigarettes consumed per day was reduced in all subjects in the failure group.ResultsSerum apolipoprotein A-I (apoA-I) and high-density lipoprotein cholesterol (HDL-C) levels significantly increased from baseline to 12 weeks in the success group (apoA-I: 151.7 ± 28.0 vs. 158.6 ± 27.3 mg/dL, respectively, p < 0.01; HDL-C: 54.6 ± 15.7 vs. 57.9 ± 14.3 mg/dL, respectively, p < 0.01); however, there were no statistically significant differences observed in the failure group (apoA-I, 145.9 ± 33.4 vs. 146.8 ± 34.2 mg/dL, respectively, p = 0.87; HDL-C, 52.6 ± 15.7 vs. 53.3 ± 16.3 mg/dL, respectively, p = 0.80). The effect sizes (Cohen's d) of apoA-I and HDL-C in the success group were 0.42 and 0.46, respectively. The post hoc statistical power values of apoA-I and HDL-C in the success group were 0.94 and 0.96, respectively.ConclusionThese findings suggest that successful smoking cessation therapy with varenicline improves serum apoA-I and HDL-C levels in the short term.