Review shows combined pharmacotherapies best for cessation
Thomas KH, Dalili MN, Lopez-Lopez JA, et al. Comparative clinical effectiveness and safety of tobacco cessation pharmacotherapies and electronic cigarettes: a systematic review and network meta-analysis of randomized controlled trials Addiction. Review. First published 11 October 2021, The authors identified 363 trials for effectiveness and 355 for safety. Most monotherapies and combination therapies were more effective than placebo at helping participants to achieve sustained abstinence; the most effective of these, estimated with some imprecision, were varenicline standard [OR = 2.83, 95% credible interval (CrI) = 2.34–3.39] and varenicline standard + NRT standard (OR = 5.75, 95% CrI = 2.27–14.88). Estimates were higher in smokers receiving counseling than in those without and in studies with higher baseline nicotine dependence scores than in those with lower scores. Varenicline standard + NRT standard showed a high probability of being ranked best or second-best.
E-cigarettes: Referencing a review of the Cochrane Database Syst Rev. 2020 (10:CD010216), authors state, “Our results were also comparable to those of the latest relevant Cochrane Systematic Reviews: we similarly found very imprecise evidence that e-cigarettes led to higher quit rates than placebo and NRT.”
https://onlinelibrary.wiley.com/doi/full/10.1111/add.15675
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Stephen Hamann
