A study funded by the NIHR found that combination therapies, especially varenicline and nicotine replacement therapy (NRT), were the most effective in helping people quit smoking.
The study, led by the University of Bristol, is the largest of its kind and has been published Dependence this week.
Vareniclin, bupropion, and NRT are recommended by the National Institutes of Health and Care Excellence (NICE) as a first-line treatment to stop smoking. E-cigarettes can be used as an adjunct to quitting smoking, but there are currently no medically licensed e-cigarettes in the UK. Because smoking is a leading cause of premature death and disease globally – and costly – the goal of the study was to study the clinical efficacy and safety of varenicline, bupropion, NRT, and e-cigarettes compared to each other.
Previous reviews of smoking cessation drugs have rarely investigated combinations of pharmacotherapy, monotherapy, or combination NRT for smoking cessation. Concerns have also been raised about the safety of e-cigarettes in the United States following the spread of severe lung damage in users of tetrahydrocannabinol (THC) e-cigarettes, especially those obtained from unofficial sources such as friends and online dealers.
The researchers identified 363 tests for effectiveness and 355 for safety. Most single and combination therapies were more effective than placebo in helping people stop smoking – varenicline monotherapy and varenicline plus NRT were the most effective together. Bupropion was also shown to be effective, but was associated with an increased risk of a serious adverse event. E-cigarettes have promised, but more research is needed to determine their safety.
Dr. Kyla Thomas, Senior Lecturer in Public Health Medicine at Bristol Medical School: Population Health Sciences (PHS) at Bristol University and lead author: “Although e-cigarettes promise as a means to stop smoking, more research is needed on their long-term efficacy and safety, preferably in studies with active interventions such as comparative.
“We also recommend additional research to investigate the effectiveness of pharmacological treatment combined with counseling or psychological interventions.”
Dr. Michael Dalili, Chief Public Health Researcher, Bristol School of Medicine: PHS and co-author, He added: “Our study strengthens the evidence base for the use of varenicline and NRT monotherapy as a first-line option for smoking cessation in line with existing NICE recommendations. Our findings should reassure patients, clinicians and politicians about the safety of these treatments. ”
The findings could affect the licensing of smoking cessation treatments, as e-cigarettes and combination therapies are currently unlicensed and may affect recommended treatments.
NICE will soon introduce new guides “Tobacco: prevention, smoking cessation and treatment of addiction”, will contain information from this study.
Learn more about this research project page.