The Association of Benzodiazepine Use with Smoking Cessation Among Hospitalized Smokers in a Clinical Trial

Abstract

Objective: Benzodiazepines are an increasingly prescribed class of anxiolytic medications that target GABA-A receptors in the brain. Smoking also has indirect effects on GABA receptors. This secondary data analysis evaluates the effects of benzodiazepine use on smoking cessation rates among participants in a hospital-based cessation trial. To our knowledge, no other study has examined the effect of benzodiazepine use on smoking cessation rates. Methods: Data from the Enhancing Quitline Utilization among In-Patients (EQUIP) study was analyzed as part of a secondary data analysis. Participants with a benzodiazepine prescription listed on their hospital discharge medication list were compared with those without a benzodiazepine prescription (total n=1054). Similar analyses were conducted between participants with either a long- or short-acting benzodiazepine prescription. Results: A logistic regression modeling the odds of a participant quitting showed no statistical association with benzodiazepine prescription presence (Odds Ratio, OR, 0.93, 95% confidence interval 0.68, 1.28). Controlling for potential covariates maintained a negatively associated, non-significant OR of 0.88 (95% confidence interval 0.63, 1.22). Additionally, the logistic regression modeling produced non-significant odds ratios for both unadjusted and adjusted associations of long-acting versus short-acting benzodiazepine prescription presence on quit rates (adjusted O.R. 0.88, 95% confidence interval 0.49, 1.61). Conclusions: In this sample of patients, the presence of a benzodiazepine prescription at discharge did not have a significant effect on 6-month biochemically verified quit rates. The odds of being quit based on the presence of a benzodiazepine prescription at discharge trended negatively across all unadjusted and adjusted analyses.