Combination Therapies To Be First Line Choices For Tobacco C
A study aimed to determine how varenicline, bupropion, nicotine replacement therapy (NRT) and electronic cigarettes compare with respect to their clinical effectiveness and safety. Researchers searched databases for systematic reviews and bayesian network meta-analyses of randomized controlled trials, in any setting, of varenicline, bupropion, NRT and e-cigarettes in adult smokers and smokeless tobacco users with follow-up duration of 24 weeks or greater (effectiveness) or any duration (safety). They identified 363 trials for effectiveness and 355 for safety. Results showed that most monotherapies and combination therapies were more effective than placebo at helping participants to achieve sustained abstinence and the most effective of these, estimated with some imprecision, were varenicline standard and varenicline standard plus NRT standard. Estimates were higher in smokers receiving counselling than in those without and in studies with higher baseline nicotine dependence scores than in those with lower scores.This study strengthens the evidence base for the use of varenicline and NRT monotherapies as first line choices for tobacco cessation in line with current NICE recommendations and could have implications on the licensing of smoking cessation treatments, as e-cigarettes and combination therapies are currently unlicensed, and could influence recommended treatments.

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