Safety of varenicline as an aid to smoking cessation in professional drivers and its impact on driving behaviors: An observational cohort study of taxi drivers in Beijing

INTRODUCTION: Varenicline is an effective smoking cessation medicine. However, the possible adverse neuropsychiatric events reported by Food and Drug Administration for varenicline may cause safety problems for professional drivers. We aimed to investigate its safety and impacts on driving behaviors among taxi drivers in Beijing, China. METHODS: An observational cohort study was conducted in a smoking cessation clinic in Beijing, China, between September 2017 and April 2018. Smokers with varenicline for smoking cessation were included and categorized into taxi-driver smokers (n=103) and non-taxi-driver smokers (n=119). All participants received varenicline up to 12 weeks and five standardized counseling sessions. Treatment-related adverse events (AEs) were collected in all participants and their impacts on driving behaviors were assessed in taxi-driver smokers. Multiple logistic regression analysis was used to examine potential risk factors for vareniclinerelated somnolence/fatigue. RESULTS: The incidence of most treatment-related AEs was similar between taxi-driver smokers and non-taxi-driver smokers, but treatment-related somnolence/ fatigue was more frequently reported in taxi-driver smokers (18.4% vs 6.7%; p=0.008). Most taxi-driver smokers (87.4%) reported that treatment-related AEs did not affect their driving behaviors, and no traffic accident was reported during treatment. CONCLUSIONS: Varenicline appears to be a well-tolerated smoking cessation aid for Beijing taxi drivers and has less impact on driving behaviors. However, taxi-driver smokers were more likely to report somnolence/fatigue during varenicline treatment and physicians should pay more attention to this occupational population.