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Efficacy of pharmacotherapies for short-term smoking abstinance: A systematic review and meta-analysis
BACKGROUND: Smoking cessation has important immediate health benefits. The comparative short-term effectiveness of smoking cessation interventions is not well known. We aimed to determine the relative effectiveness of nicotine replacement therapy (NRT), bupropion and varenicline at 4 weeks post-targ...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2009
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760513/ https://www.ncbi.nlm.nih.gov/pubmed/19761618 http://dx.doi.org/10.1186/1477-7517-6-25 |
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author | Mills, Edward J Wu, Ping Spurden, Dean Ebbert, Jon O Wilson, Kumanan |
author_facet | Mills, Edward J Wu, Ping Spurden, Dean Ebbert, Jon O Wilson, Kumanan |
author_sort | Mills, Edward J |
collection | PubMed |
description | BACKGROUND: Smoking cessation has important immediate health benefits. The comparative short-term effectiveness of smoking cessation interventions is not well known. We aimed to determine the relative effectiveness of nicotine replacement therapy (NRT), bupropion and varenicline at 4 weeks post-target quit date. METHODS: We searched 10 electronic medical databases (inception to October 2008). We selected randomized clinical trials [RCTs] evaluating interventions for our primary outcome of abstinence 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 compared treatment effects across interventions using head-to-head trials and calculated indirect comparisons. RESULTS: We combined a total of 101 trials evaluating delivery of NRT versus inert controls at approximately 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 trials contributing 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 for cessation 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 a pooled 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; varenicline and 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 abstinence rates in the short-term. |
format | Text |
id | pubmed-2760513 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2009 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-27605132009-10-13 Efficacy of pharmacotherapies for short-term smoking abstinance: A systematic review and meta-analysis Mills, Edward J Wu, Ping Spurden, Dean Ebbert, Jon O Wilson, Kumanan Harm Reduct J Research BACKGROUND: Smoking cessation has important immediate health benefits. The comparative short-term effectiveness of smoking cessation interventions is not well known. We aimed to determine the relative effectiveness of nicotine replacement therapy (NRT), bupropion and varenicline at 4 weeks post-target quit date. METHODS: We searched 10 electronic medical databases (inception to October 2008). We selected randomized clinical trials [RCTs] evaluating interventions for our primary outcome of abstinence 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 compared treatment effects across interventions using head-to-head trials and calculated indirect comparisons. RESULTS: We combined a total of 101 trials evaluating delivery of NRT versus inert controls at approximately 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 trials contributing 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 for cessation 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 a pooled 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; varenicline and 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 abstinence rates in the short-term. BioMed Central 2009-09-18 /pmc/articles/PMC2760513/ /pubmed/19761618 http://dx.doi.org/10.1186/1477-7517-6-25 Text en Copyright © 2009 Mills et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Mills, Edward J Wu, Ping Spurden, Dean Ebbert, Jon O Wilson, Kumanan Efficacy of pharmacotherapies for short-term smoking abstinance: A systematic review and meta-analysis |
title | Efficacy of pharmacotherapies for short-term smoking abstinance: A systematic review and meta-analysis |
title_full | Efficacy of pharmacotherapies for short-term smoking abstinance: A systematic review and meta-analysis |
title_fullStr | Efficacy of pharmacotherapies for short-term smoking abstinance: A systematic review and meta-analysis |
title_full_unstemmed | Efficacy of pharmacotherapies for short-term smoking abstinance: A systematic review and meta-analysis |
title_short | Efficacy of pharmacotherapies for short-term smoking abstinance: A systematic review and meta-analysis |
title_sort | efficacy of pharmacotherapies for short-term smoking abstinance: a systematic review and meta-analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760513/ https://www.ncbi.nlm.nih.gov/pubmed/19761618 http://dx.doi.org/10.1186/1477-7517-6-25 |
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