OBJECTIVE Heavy drinking is common among smokers and is associated with especially poor health outcomes. Varenicline may affect mechanisms and clinical outcomes that are relevant for both smoking cessation and alcohol use. The current study examines whether varenicline, relative to nicotine replacement therapy, yields better smoking cessation outcomes among binge drinking smokers. METHOD Secondary data analyses of a comparative effectiveness randomized controlled trial of three smoking cessation pharmacotherapies (12 weeks of varenicline, nicotine patch, or nicotine patch and lozenge) paired with six counseling sessions were conducted. Adult daily cigarette smokers (N = 1,078, 52% female) reported patterns of alcohol use, cigarette craving, and alcohol-related cigarette craving at baseline and over 4 weeks after quitting. Smoking cessation outcome was 7-day biochemically confirmed point-prevalence abstinence. RESULTS Binge drinkers had higher relapse rates than moderate drinkers at 4-week post-target quit day but not at the end of treatment or long-term follow up (12 and 26 weeks). Varenicline did not yield superior smoking cessation outcomes among binge drinkers, nor did it affect alcohol use early in the quit attempt. Varenicline did produce relatively large reductions in alcohol-related cigarette craving and overall cigarette craving during the first 4 weeks after quitting. CONCLUSIONS Varenicline did not yield higher smoking abstinence rates or reduce alcohol use among binge drinkers. Varenicline did reduce alcohol-related cigarette craving but this did not translate to meaningful differences in smoking abstinence. Varenicline's effects on smoking abstinence do not appear to vary significantly as a function of drinking status.

中文翻译：

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搜索暴饮暴食者的个性化药物：使用瓦伦尼克碱，尼古丁贴片或尼古丁替代疗法联合戒烟

目的大量饮酒在吸烟者中很普遍，并且与健康状况特别差有关。瓦伦尼克林可能会影响与戒烟和饮酒有关的机制和临床结果。当前的研究检查了相对于尼古丁替代疗法而言，伐尼克兰是否在暴饮暴食吸烟者中产生更好的戒烟结果。方法对三项戒烟药物治疗（伐尼克兰，尼古丁贴片或尼古丁贴片和锭剂）与六次咨询会议配对进行的比较有效性随机对照试验的二级数据分析。每日成年吸烟者（N = 1,078，女性占52％）报告了基线和戒烟后4周以上的饮酒习惯，烟瘾和与酒精有关的烟瘾。戒烟结局为7天生化确认的点流行戒断。结果在目标退出后的第4周，宾果饮酒者的复发率高于中度饮酒者，但在治疗结束或长期随访时（12和26周）则没有。在狂饮者中，瓦伦尼克林没有产生更好的戒烟效果，也没有影响戒烟初期的饮酒。在戒烟后的最初4周内，瓦伦尼克林确实确实减少了与酒精相关的烟瘾和总体烟瘾的减少。结论Varenicline不能在狂饮者中产生更高的戒烟率或减少饮酒。Varenicline确实减少了与酒精有关的香烟渴望，但这并未转化为戒烟的有意义差异。瓦伦尼克线