Efficacy of Pharmacotherapies for Short-Term Smoking Abstinance: A Systematic Review and Meta-Analysis

Resource type
Date created
2009
Authors/Contributors
Author: Wu, Ping
Abstract
Background:Smoking cessation has important immediate health benefits. The comparative shorttermeffectiveness of smoking cessation interventions is not well known. We aimed to determinethe relative effectiveness of nicotine replacement therapy (NRT), bupropion and varenicline at 4weeks post-target quit date.Methods:We searched 10 electronic medical databases (inception to October 2008). Weselected randomized clinical trials [RCTs] evaluating interventions for our primary outcome ofabstinence from smoking at at-least 4 weeks post-target quit date, with biochemical confirmation.We conducted random-effects odds ratio (OR) meta-analysis and meta-regression. We comparedtreatment effects across interventions using head-to-head trials and calculated indirectcomparisons.Results:We combined a total of 101 trials evaluating delivery of NRT versus inert controls atapproximately 4 weeks post-target quit date (total n = 31,321). The pooled overall OR is OR 2.05(95% Confidence Interval [CI], 1.89-2.23, P =< 0.0001). We pooled data from 31 bupropion trialscontributing a total n of 11,118 participants and found a pooled OR of 2.25 (95% CI, 1.94-2.62, P=< 0.0001). We evaluated 9 varenicline trials compared to placebo. Our pooled estimate forcessation at 4 weeks post-target quit date found a pooled OR of 3.16 (95% CI, 2.55-3.91, P =<0.0001). Two trials evaluated head to head comparisons of varenicline and bupropion and found apooled estimate of OR 1.86 (95% CI, 1.49-2.33, P =< 0.0001 at 4 weeks post-target quit date.Indirect comparisons were: NRT and bupropion, OR, 1.09, 95% CI, 0.93-1.31, P = 0.28; vareniclineand NRT, OR 1.56, 95% CI, 1.23-1.96, P = 0.0002; and, varenicline and bupropion, OR 1.40, 95%CI, 1.08-1.85, P = 0.01.Conclusion:Pharmacotherapeutic interventions are effective for increasing smoking abstinencerates in the short-term.
Document
Published as
Harm Reduction Journal 2009, 6:25 doi:10.1186/1477-7517-6-25
Publication title
Harm Reduction Journal
Document title
Efficacy of Pharmacotherapies for Short-Term Smoking Abstinance: A Systematic Review and Meta-Analysis
Date
2009
Volume
6
Issue
25
Publisher DOI
10.1186/1477-7517-6-25
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Copyright is held by the author(s).
Scholarly level
Peer reviewed?
Yes
Language
Member of collection
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1477-7517-6-25.pdf 1.98 MB