Pharmacological interventions for smoking cessation: an overview and network meta-analysis.

@article{Cahill2013PharmacologicalIF,
  title={Pharmacological interventions for smoking cessation: an overview and network meta-analysis.},
  author={Kate Cahill and Sarah L Stevens and Rafael Perera and Tim Lancaster},
  journal={The Cochrane database of systematic reviews},
  year={2013},
  volume={5},
  pages={
          CD009329
        }
}
BACKGROUND Smoking is the leading preventable cause of illness and premature death worldwide. Some medications have been proven to help people to quit, with three licensed for this purpose in Europe and the USA: nicotine replacement therapy (NRT), bupropion, and varenicline. Cytisine (a treatment pharmacologically similar to varenicline) is also licensed for use in Russia and some of the former socialist economy countries. Other therapies, including nortriptyline, have also been tested for… 

Figures and Tables from this paper

Varenicline and combination nicotine replacement therapy are the most effective pharmacotherapies for treating tobacco use

  • J. Ebbert
  • Medicine, Political Science
    Evidence-Based Medicine
  • 2013
TLDR
An overview and network meta-analysis of pharmacological interventions for smoking cessation and their comparative efficacies and risks are conducted to help guide treatment, policy and future research.

How do smoking cessation medicines compare with respect to their neuropsychiatric safety? A protocol for a systematic review, network meta-analysis and cost-effectiveness analysis

TLDR
A protocol is presented for a systematic review and network meta-analysis to determine how these smoking cessation medicines compare to each other with respect to their neuropsychiatric safety in adult smokers and to update the evidence regarding the effectiveness and cardiovascular safety of these medicines for use in a cost-effectiveness analysis.

The safety of treatments for tobacco use disorder

TLDR
An overview of current evidence on the safety of first-line pharmacotherapies for the treatment of tobacco use disorder includes nicotine replacement therapy, bupropion sustained-release (SR), and varenicline.

Sex Differences in Smoking Cessation Pharmacotherapy Comparative Efficacy: A Network Meta-analysis

TLDR
The advantage of varenicline over bupropion SR and TN is greater for women than men, and Clinicians should strongly consider varenICline as the first option treatment for women, while among men, the advantage is less clear.

Antidepressants for smoking cessation.

TLDR
High-certainty evidence that bupropion increased long-term smoking cessation rates was found, and there was insufficient evidence to establish whether participants taking buPropion were more likely to report SAEs compared to those taking placebo, or whether combination bu Propion and nicotine replacement therapy resulted in superior quit rates to NRT alone.

Cardiovascular Events Associated With Smoking Cessation Pharmacotherapies: A Network Meta-Analysis

TLDR
Smoking cessation therapies do not appear to raise the risk of serious cardiovascular disease events, and the use of cessation medications is recommended to increase the likelihood of quitting.

Varenicline for smoking cessation: a narrative review of efficacy, adverse effects, use in at-risk populations, and adherence

TLDR
Evidence is strong that varenicline is safe and effective in treating tobacco dependence among people who are at higher risk for neuropsychiatric symptoms and cardiovascular disease and by taking it in combination with other medications, enhancing patient adherence and extending the duration of treatment.

Smoking cessation medicines and e-cigarettes: a systematic review, network meta-analysis and cost-effectiveness analysis.

TLDR
Effect modification for counselling and dependence was found, with a higher proportion of smokers who received counselling achieving sustained abstinence than those who did not receive counselling, and higher odds of sustained abstinence among participants with higher average dependence scores.

Pharmacotherapy to Quit: Beyond the Guidelines

TLDR
One study showed that a flexible quit date approach had similar efficacy compared with fixed quit date using varenicline, and pre-quit NRT may be associated with higher attempts to quit and success.

Comparative Effectiveness of Smoking Cessation Medications: A National Prospective Cohort From Taiwan

TLDR
In smoking cessation clinics in Taiwan, varenicline users reported higher abstinence rates than NRT patch users after 6 months, suggesting women and smokers with light/moderate nicotine dependence may also benefit from varenICline in actual clinical practice.
...

References

SHOWING 1-10 OF 97 REFERENCES

Effectiveness of smoking cessation therapies: a systematic review and meta-analysis

TLDR
NRT, bupropion and varenicline all provide therapeutic effects in assisting with smoking cessation by conducting a systematic review and meta-analysis and indirect comparisons identify a hierarchy of effectiveness.

Interventions for smoking cessation and reduction in individuals with schizophrenia.

TLDR
Bupropion increases smoking abstinence rates in smokers with schizophrenia, without jeopardizing their mental state and varenicline may also improve smoking cessation rates in schizophrenia, but its possible psychiatric adverse effects cannot be ruled out.

Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials

TLDR
A meta-analysis to compare the treatment effects of 7 approved pharmacologic interventions for smoking cessation found that varenicline was superior to bupropion and all were more efficacious than placebo at promoting smoking abstinence at 6 and 12 months.

Adverse events associated with nicotine replacement therapy (NRT) for smoking cessation. A systematic review and meta-analysis of one hundred and twenty studies involving 177,390 individuals

TLDR
A systematic review and meta-analysis aimed to identify all randomized clinical trials (RCTs) of NRT versus inert controls and all observational studies to determine the magnitude of reported adverse effects with NRT and found the use of N RT is associated with a variety of side effects.

Pharmacological interventions for promoting smoking cessation during pregnancy.

TLDR
The primary efficacy outcome was smoking cessation in later pregnancy (in all but one trial, at or around delivery); safety was assessed by 11 outcomes that indicated neonatal and infant well-being; and adherence with trial NRT regimens was low.

Anxiolytics for smoking cessation.

TLDR
None of the trials showed strong evidence of an effect for any of these drugs in helping smokers to quit, but the available evidence does not rule out a possible effect.

Nicotine replacement therapy for smoking cessation.

TLDR
The effectiveness of NRT appears to be largely independent of the intensity of additional support provided to the smoker, and the combination of bupropion and nicotine patch was significantly more effective than nicotine patch alone.

Efficacy and Safety of Varenicline for Smoking Cessation in Patients With Cardiovascular Disease: A Randomized Trial

TLDR
Varenicline was well tolerated and did not increase cardiovascular events or mortality; however, trial size and duration limit definitive conclusions about safety.

Interventions for smokeless tobacco use cessation.

TLDR
Behavioural interventions should be used to help ST users to quit and telephone counselling or an oral examination may increase abstinence rates more than interventions without these components.

Efficacy of cytisine in helping smokers quit: systematic review and meta-analysis

TLDR
Cytisine is an effective treatment for smoking cessation with efficacy comparable to that of other currently licensed treatments, Given its low cost and potential for public health benefit, expedited licensing of cytisine forsmoking cessation is warranted.
...