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JAMA Clinical Evidence Synopsis |

Pharmacological Treatments for Smoking Cessation

Kate Cahill, BA1,2; Sarah Stevens, MSc1; Tim Lancaster, MBBS, FRCGP1,2
[+] Author Affiliations
1Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
2Cochrane Tobacco Addiction Group, University of Oxford, Oxford, United Kingdom
JAMA. 2014;311(2):193-194. doi:10.1001/jama.2013.283787.
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Clinical Question  Among the 3 first-line smoking cessation treatments (nicotine replacement therapy [NRT], bupropion, and varenicline), which is most effective in helping people who smoke achieve and maintain abstinence from smoking for at least 6 months, and what serious adverse events are associated with each?

Bottom Line  Higher rates of smoking cessation were associated with NRT (17.6%) and bupropion (19.1%) compared with placebo (10.6%). Varenicline (27.6%) and combination NRT (31.5%) (eg, patch plus inhaler) were most effective for achieving smoking cessation. None of the therapies was associated with an increased rate of serious adverse events.

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Figure.
Odds Ratios for Smoking Abstinence of 6 Months or More

Source: Data have been adapted with permission from the Cochrane Collaboration and Wiley.1 NA indicates not available; NRT, nicotine replacement therapy (any type, single or combination). Credible interval is the Bayesian equivalent of confidence interval and is interpreted the same way as confidence interval. For varenicline vs NRT, indirect comparison was generated by the network analysis.

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