E-Cigarettes, Cytisine, Varenicline Most Effective to Help Stop Smoking

Combination of a patch and fast-acting nicotine replacement therapy also effective

By Lori Solomon HealthDay Reporter

FRIDAY, Sept. 15, 2023 (HealthDay News) — Electronic cigarettes and the medicines cytisine and varenicline appear to help the most people to quit smoking, according to a review published online Sept. 12 in the Cochrane Library.

Nicola Lindson, Ph.D., from University of Oxford in the United Kingdom, and colleagues investigated the comparative benefits, harms, and tolerability of different smoking cessation pharmacotherapies and e-cigarettes to help people stop smoking tobacco.

Based on 319 randomized controlled trials (157,179 participants), the researchers found with high-certainty evidence that nicotine e-cigarettes (odds ratio, 2.37; 16 trials), varenicline (odds ratio, 2.33; 67 trials), and cytisine (odds ratio, 2.21; seven trials) were associated with higher quit rates than control, each yielding an additional seven or eight quitters per 100. The combination of nicotine replacement therapy (patch plus a fast-acting form) was also effective (odds ratio, 1.93). Overall, the rates of serious adverse events were low (average, 3 percent) for treatments, excluding nortriptyline and non-nicotine e-cigarettes. Removing the 104 studies at high risk for bias did not alter the results.

“More head-to-head comparisons of the most effective interventions are needed, as are tests of combinations of these,” the authors write. “Future work should unify data from behavioral and pharmacological interventions to inform approaches to combined support for smoking cessation.”