Please note this application is under active development. If you spot any errors or something isn't working, please contact us at evidence.service@wales.nhs.uk.

Smoking cessation medicines and e-cigarettes: a systematic review, network meta-analysis and cost-effectiveness analysis

Thomas KH el al (2021)

Health Technology Assessment - 10.3310/hta25590

Evidence Categories

  • Care setting: Healthcare Setting
  • Care setting: Workplace setting
  • Care setting: Educational Setting
  • Care setting: Supported living/care homes
  • Population group: Adults
  • Intervention: Bupropian
  • Intervention: Electronic Nicotine Delivery System
  • Intervention: Nicotine Replacement Therapy
  • Intervention: Varenicline
  • Outcome: Smoking cessation

Type of Evidence

Systematic Review

Aims

To determine the clinical effectiveness, safety and cost-effectiveness of smoking cessation medicines and e-cigarettes.

Findings

Most monotherapies and combination treatments were more effective than placebo at achieving sustained abstinence. Varenicline standard plus nicotine replacement therapy standard (odds ratio 5.75, 95% credible interval 2.27 to 14.90) was ranked first for sustained abstinence, followed by e-cigarette low (odds ratio 3.22, 95% credible interval 0.97 to 12.60), although these estimates have high uncertainty. The authors found effect modification for counselling and dependence, with a higher proportion of smokers who received counselling achieving sustained abstinence than those who did not receive counselling, and higher odds of sustained abstinence among participants with higher average dependence scores. The authors found that bupropion standard increased odds of serious adverse events compared with placebo (odds ratio 1.27, 95% credible interval 1.04 to 1.58). 

Conclusions

Combined therapies of medicines are among the most clinically effective, safe and cost-effective treatment options for smokers. Although the combined therapy of nicotine replacement therapy and varenicline at standard doses was the most effective treatment, this is currently unlicensed for use in the UK.

Also In This Category