scholarly journals Randomized trial of nicotine replacement therapy ( NRT) , bupropion and NRT plus bupropion for smoking cessation: effectiveness in clinical practice

Addiction ◽  
2013 ◽  
Vol 108 (12) ◽  
pp. 2193-2201 ◽  
Author(s):  
John Stapleton ◽  
Robert West ◽  
Peter Hajek ◽  
Jenny Wheeler ◽  
Eleni Vangeli ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Clinical Practice ◽  
Randomized Trial ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Nicotine Replacement

scholarly journals Lack of Association of 5-HTTLPR Genotype with Smoking Cessation in a Nicotine Replacement Therapy Randomized Trial

2006 ◽  
Vol 15 (2) ◽  
pp. 398-400 ◽  
Author(s):  
Marcus R. Munafò ◽  
Elaine C. Johnstone ◽  
E. Paul Wileyto ◽  
Peter G. Shields ◽  
Katherine M. Elliot ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Randomized Trial ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Nicotine Replacement

scholarly journals Association of COMT Val108/158Met Genotype with Smoking Cessation in a Nicotine Replacement Therapy Randomized Trial

2007 ◽  
Vol 16 (6) ◽  
pp. 1065-1069 ◽  
Author(s):  
Elaine C. Johnstone ◽  
Katherine M. Elliot ◽  
Sean P. David ◽  
Michael F.G. Murphy ◽  
Robert T. Walton ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Randomized Trial ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Nicotine Replacement

scholarly journals Varenicline versus nicotine replacement therapy for long-term smoking cessation: an observational study using the Clinical Practice Research Datalink

2020 ◽  
Vol 24 (9) ◽  
pp. 1-46
Author(s):  
Neil M Davies ◽  
Amy E Taylor ◽  
Gemma MJ Taylor ◽  
Taha Itani ◽  
Tim Jones ◽  
...  
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Clinical Practice ◽  
Confidence Interval ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Instrumental Variable ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Nicotine Replacement

Background Smoking is the leading avoidable cause of illness and premature mortality. The first-line treatments for smoking cessation are nicotine replacement therapy and varenicline. Meta-analyses of experimental studies have shown that participants allocated to the varenicline group were 1.57 times (95% confidence interval 1.29 to 1.91 times) as likely to be abstinent 6 months after treatment as those allocated to the nicotine replacement therapy group. However, there is limited evidence about the effectiveness of varenicline when prescribed in primary care. We investigated the effectiveness and rate of adverse events of these medicines in the general population. Objective To estimate the effect of prescribing varenicline on smoking cessation rates and health outcomes. Data sources Clinical Practice Research Datalink. Methods We conducted an observational cohort study using electronic medical records from the Clinical Practice Research Datalink. We extracted data on all patients who were prescribed varenicline or nicotine replacement therapy after 1 September 2006 who were aged ≥ 18 years. We investigated the effects of varenicline on smoking cessation, all-cause mortality and cause-specific mortality and hospitalisation for: (1) chronic lung disease, (2) lung cancer, (3) coronary heart disease, (4) pneumonia, (5) cerebrovascular disease, (6) diabetes, and (7) external causes; primary care diagnosis of myocardial infarction, chronic obstructive pulmonary disease, depression, or prescription for anxiety; weight in kg; general practitioner and hospital attendance. Our primary outcome was smoking cessation 2 years after the first prescription. We investigated the baseline differences between patients prescribed varenicline and patients prescribed nicotine replacement therapy. We report results using multivariable-adjusted, propensity score and instrumental variable regression. Finally, we developed methods to assess the relative bias of the different statistical methods we used. Results People prescribed varenicline were healthier at baseline than those prescribed nicotine replacement therapy in almost all characteristics, which highlighted the potential for residual confounding. Our instrumental variable analysis results found little evidence that patients prescribed varenicline had lower mortality 2 years after their first prescription (risk difference 0.67, 95% confidence interval –0.11 to 1.46) than those prescribed nicotine replacement therapy. They had similar rates of all-cause hospitalisation, incident primary care diagnoses of myocardial infarction and chronic obstructive pulmonary disease. People prescribed varenicline subsequently attended primary care less frequently. Patients prescribed varenicline were more likely (odds ratio 1.46, 95% confidence interval 1.42 to 1.50) to be abstinent 6 months after treatment than those prescribed nicotine replacement therapy when estimated using multivariable-adjusted for baseline covariates. Patients from more deprived areas were less likely to be prescribed varenicline. However, varenicline had similar effectiveness for these groups. Conclusion Patients prescribed varenicline in primary care were more likely to quit smoking than those prescribed nicotine replacement therapy, but there was little evidence that they had lower rates of mortality or morbidity in the 4 years following the first prescription. There was little evidence of heterogeneity in effectiveness across the population. Future work Future research should investigate the decline in prescribing of smoking cessation products; develop an optimal treatment algorithm for smoking cessation; use methods for using instruments with survival outcomes; and develop methods for comparing multivariable-adjusted and instrumental variable estimates. Limitations Not all of our code lists were validated, body mass index and Index of Multiple Deprivation had missing values, our results may suffer from residual confounding, and we had no information on treatment adherence. Trial registration This trial is registered as NCT02681848. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 9. See the NIHR Journals Library website for further project information.

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