Most effective stop-smoking aids measured

A new study has looked into the benefits and harms of various smoking cessation approaches.

Dr Nicola Lindson, of the University of Oxford, UK, and colleagues found that the most effective interventions were the pharmaceuticals varenicline and cytisine, as well as nicotine e‐cigarettes.

In Cochrane Database of Systematic Reviews yesterday, they write: “Tobacco smoking is the leading preventable cause of death and disease worldwide. Stopping smoking can reduce this harm and many people would like to stop.”

They analysed information from 319 trials that measured smoking cessation at six months or longer, covering 157,179 participants.

The evidence for nicotine e‐cigarettes, varenicline and cytisine was described as “high quality” in terms of improving quit rates.

Combination nicotine replacement therapy also appeared effective, but less so. The evidence of effectiveness was less good for nortriptyline and non‐nicotine e‐cigarettes.

Serious side-effects were rare but should be reported more carefully in future studies, the authors state.

“Future work should also unify data from behavioural and pharmacological interventions,” they write.

Dr Lindson said: “Our research dives deep into the world of smoking cessation. By pulling together data from hundreds of studies and over 150,000 people, we can see that when people use the medicines licenced for quitting smoking or nicotine e-cigarettes, they are more likely to quit than if they do not use these aids.”

However, she adds that cytisine is not currently licensed or marketed in most countries outside of central and Eastern Europe and varenicline is not currently available in Europe, South America, Japan, and parts of North America due to a manufacturing problem.

“This leaves nicotine e-cigarettes and combination nicotine replacement therapies as the two most effective stop-smoking aids available to most people,” she concludes.

Lindson, N. et al. Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses. Cochrane Database of Systematic Reviews 12 September 2023; doi: 10.1002/14651858.CD015226.pub2


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