Introduction Varenicline is the most effective pharmacotherapy for successful quit attempts, however associated with cardiovascular (CV) and neuropsychiatric adverse events. To date, abstinence rate and incidence of adverse events with varenicline use and smoker characteristics related to successful smoking cessation attempts have not been widely studied. This study aimed to determine the prevalence of smoking abstinence and incidence of adverse events among varenicline users. Methods Study Design Retrospective cohort study Study Site 22 government-operated quit smoking clinics in the state of Perak, Malaysia. Data Collection Tool Standard data collection form Ethics Approval MREC (KKM.NIHSEC.P18-2294(5)) Results [Refer to Poster]. Discussion and Conclusion Mean duration of treatment was approximately 1-month shorter than recommended duration. Extending treatment duration by improving adherence and prevent dropout may increase smoking abstinence rate. Subjects at preparation and action stage had significant higher odds to quit. Change in level of readiness can be pursued first before initiating pharmacotherapy to better allocate limited resources and produce better treatment outcomes. Intolerance to adverse events and withdrawal symptoms even though minor has led to treatment termination and failure to achieve smoking abstinence. Treatment and counselling to cope with intolerable symptoms can be provided. In conclusion, majority of the subjects achieved smoking abstinence with varenicline use. Although uncommon, infrequent incidences of CV and neuropsychiatric adverse events were reported, warranting need for continuous surveillance and adverse drug reaction reporting.