Meta-analysis on efficacy of nicotine replacement therapies in smoking cessation

The Lancet ◽  
1994 ◽  
Vol 343 (8890) ◽  
pp. 139-142 ◽  
Author(s):  
C. Silagy ◽  
D. Mant ◽  
G. Fowler ◽  
M. Lodge
Keyword(s):  
Smoking Cessation ◽  
Meta Analysis ◽  
Nicotine Replacement

scholarly journals Evaluating level of adherence to nicotine replacement therapy and its impact on smoking cessation: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039775 ◽  
Author(s):  
Amanual Getnet Mersha ◽  
Parivash Eftekhari ◽  
Michelle Bovill ◽  
Daniel Nigusse Tollosa ◽  
Gillian Sandra Gould
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Population Based ◽  
Reverse Causality ◽  
Nicotine Replacement

IntroductionNicotine replacement therapy (NRT) has proven effective for smoking cessation in clinical trials, however it was found less effective in population-based studies, potentially due to inconsistent or incorrect use of NRT. The aim of this paper is to describe a systematic review protocol to evaluate level of adherence to NRT; the discrepancy of adherence to NRT in clinical and population-based studies and degree of association between level of adherence and success of smoking cessation.Methods and analysisLiterature search will use five databases (Medline, Scopus, Embase, CINAHL and PsycINFO). Studies will be appraised for methodological quality using National Institutes of Health Quality Assessment Tool. To reduce heterogeneity, we will analyse clinical trials and population-based studies separately; pooled analyses will be done among studies that used similar measurements. Heterogeneity of studies will be assessed by Higgins’ I2 statistical test. When studies are adequately homogeneous, results will be pooled using random-effects model with proportion and ORs with 95% CIs and p values for each outcome. We will explain sources of heterogeneity by subgroup analysis or sensitivity analysis. Funnel plots and Egger’s regression asymmetry test with p<0.05 will be used as a cut-off point to affirm presence of statistically significant publication bias. Statistical analyses will be carried out using Stata V.16 software. Only studies reporting a valid strategy to control for reverse causality will be included.DiscussionThis review will provide evidence to support the importance of adherence on rate of smoking cessation and level of adherence to NRT. The findings will be used to inform smoking cessation interventions, researchers and policymakers.Ethics and disseminationAs a systematic literature review, this protocol does not require ethics approval. Research outcomes will be presented at relevant conferences and findings will be published in a relevant peer-reviewed journal.PROSPERO registration numberCRD42020176749.

Effectiveness of Varenicline versus Combination Nicotine Replacement Therapy for Smoking Cessation: One Year Outcomes in a Smoking Cessation Clinic in Taiwan

2021 ◽  
Author(s):  
Kuang-Chieh Hsueh ◽  
Pei-Ling Tang ◽  
Hayden McRobbie
Keyword(s):  
Smoking Cessation ◽  
Meta Analysis ◽  
Primary Outcome Measure ◽  
Abstinence Rate ◽  
Nicotine Replacement ◽  
Quit Attempt ◽  
Replacement Treatment ◽  
Long Term Follow Up ◽  
Cessation Clinic ◽  
Smoking Cessation Clinic

Abstract Introduction Varenicline and combination nicotine replacement treatment (cNRT) have been recommended as the most effective pharmacotherapies, with equal abstinence rate for smoking cessation in a network meta-analysis of randomized trials, but data from real-world long-term follow-up studies are rare. This study aimed to compare the 12-month sustained abstinence rates of smokers using varenicline versus cNRT in their quit attempt. Methods A total of 3,569 smokers were recruited via the Department of Family Medicine outpatient department at Kaohsiung Veteran General Hospital between June 2013 and March 2019. Participants received counseling from a physician and chose either varenicline (N=2,870) or cNRT (N=699) for smoking cessation. Both varenicline and cNRT users could receive a free 8-week supply and 8 clinic visits over 90 days. Participants were followed-up by telephone at 12, 24, and 52 weeks from first visit. The primary outcome measure of the study was self-reported sustained abstinence up to 52 weeks. Results Varenicline users had a significantly higher sustained abstinence rate weeks 12-52, adjusted for baseline variables (15.2% vs. 10.3%, p=0.001; aOR= 1.47, 95%CI: 1.05–2.05). Other significant predictors of 52 weeks sustained abstinence were being male, having a higher income, attending more clinical visits and have lower nicotine dependence. Conclusion Varenicline appears to have higher sustained abstinence rates to 52 weeks compared with cNRT, in a smoking cessation clinic where smokers can choose their medication option.

scholarly journals Evaluating level of adherence to nicotine replacement therapy and its impact on smoking cessation: a systematic review and meta-analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Amanual Getnet Mersha ◽  
Parivash Eftekhari ◽  
Michelle Bovill ◽  
Daniel Nigusse Tollosa ◽  
Gillian Sandra Gould
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Pregnant Women ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Meta Analysis ◽  
Grey Literature ◽  
Population Based ◽  
P Value ◽  
Nicotine Replacement

Abstract Background Nicotine replacement therapy (NRT) has proven effect in assisting smoking cessation. However, its effectiveness varies across studies and population groups. This may be due to differences in the rate of adherence. Hence, this review aims to examine the level of adherence to NRT and to assess if the level of adherence to NRT affects success of smoking cessation. Methods A systematic review and meta-analysis was conducted using studies retrieved from five electronic databases (MEDLINE, Scopus, EMBASE, Web of science, and PsycINFO) and grey literature. Pooled analysis was conducted using Stata version 16 software. Methodological quality and risk of bias were assessed using the NIH Quality Assessment Tool. Analyses were done among those studies that used similar measurements to assess level of adherence and successful smoking cessation. Heterogeneity of studies was assessed using the Higgins’ I2 statistical test. Funnel plots and Egger’s regression asymmetry test were used to affirm presence of significant publication bias. Results A total of 7521 adult participants of 18 years old and above from 16 studies were included in the analysis. Level of adherence to NRT among participants of randomised controlled trials were found to be 61% (95% CI, 54–68%), p-value of < 0.001 and I2 = 85.5%. Whereas 26% of participants were adherent among participants of population-based studies with 95% CI, 20–32%, p-value of < 0.001 and I2 = 94.5%. Level of adherence was the lowest among pregnant women (22%) with 95% CI, 18–25%, p-value of 0.31 and I2 = 15.8%. Being adherent to NRT doubles the rate of successful quitting (OR = 2.17, 95% CI, 1.34–3.51), p-value of < 0.001 and I2 = 77.6%. Conclusions This review highlights a low level of adherence to NRT among participants of population-based studies and pregnant women as compared to clinical trials. Moreover, the review illustrated a strong association between adherence and successful smoking cessation. Hence, it is recommended to implement and assess large scale interventions to improve adherence. Health programs and policies are recommended to integrate the issue of adherence to NRT as a core component of smoking cessation interventions. Trial registration PROSPERO registration number: CRD42020176749. Registered on 28 April 2020.

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