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E-cigarettes: Varenicline and cytisine are the most effective stop-smoking aids

The findings indicate that on average, for every 100 people trying to quit, around 14 are likely to succeed using an e-cigarette, varenicline or cytisine.

Australia is about to introduce a raft of new restrictions on vaping
Australia is about to introduce a raft of new restrictions on vaping - Copyright AFP Jose Luis Magana
Australia is about to introduce a raft of new restrictions on vaping - Copyright AFP Jose Luis Magana

A new, comprehensive study reveals that nicotine e-cigarettes, varenicline (a nicotinic receptor partial agonist) and cytisine are the stop-smoking aids most likely to help people quit smoking. Despite the attributed success that cytisine is a highly effective smoking cessation medicine, the medication is unavailable in most countries, including the U.K. It is also noteworthy that many countries also have supply issues with varenicline currently.

Cytisine has been available in post-Soviet states for more than 40 years as an aid to smoking cessation under the brand name Tabex.

For the research, scientists compared the results for different stop-smoking aids that have been used in over 300 clinical trials involving more than 150,000 people. In this regard, the researchers used a statistical technique to combine data from the studies into a single analysis called “component network meta-analysis” (CNMA). This enabled the scientists to compare smoking cessation methods against each other, using both direct comparisons within trials and indirect comparisons across trials. This provided a comprehensive view of the relative effectiveness of each method.

In terms of the research importance, smoking remains a significant health concern and cause of death worldwide. However, it is very difficult to quit. There are several products available to help with this, but the relative effectiveness of these methods has long been uncertain.

The findings indicate that on average, for every 100 people trying to quit, around 14 are likely to succeed using an e-cigarette, varenicline or cytisine in any given quit attempt. This is compared to 6 in 100 who are likely to quit without using any aids. Cystisine is an alkaloid that occurs naturally in several plant genera.

In addition, dual nicotine replacement therapy (NRT) methods, such as combining a patch with gum, may be almost as effective, with approximately 12 in 100 people likely to successfully quit. However, this estimate is less certain than those for the other stop-smoking aids.

However, simply using only one form of NRT, such as a patch alone, leads to around 9 in 100 people successfully quitting.

This is based on an advanced “component network meta-analysis” (CNMA) approach. Here researchers analysed over 300 clinical trials to compare the effectiveness of various cessation methods.

The research is based on an assessment of those smokers who quit ‘long-term’ (defined as going at least six months without smoking). This is closely followed by using two forms of nicotine replacement therapy at the same time, such as a nicotine patch alongside gum, lozenges, or nasal sprays.

The research was conducted by a team from the Nuffield Department of Primary Care Health Sciences at the University of Oxford with colleagues from the University of Leicester.

Dr Nicola Lindson, lead author and a Senior Researcher and Lecturer based within Oxford’s Nuffield Department of Primary Care Health Sciences, emphasised the potential impact of the findings in a stament supplied to Digital Journal: “Our research dives deep into the world of smoking cessation. By pulling together data from hundreds of studies and over 150,000 people, we can see that when people use the medicines licenced for quitting smoking or nicotine e-cigarettes, they are more likely to quit than if they do not use these aids. We have also shown that nicotine e-cigarettes, cytisine, and varenicline appear to help more people quit than other products used to stop smoking. Nicotine replacement therapy appears to be almost as effective, but only when a patch is used alongside another form of nicotine replacement, such as gum or nasal spray.”

The study has been published in the Cochrane Database of Systematic Reviews, titled “Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses”.

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Written By

Dr. Tim Sandle is Digital Journal's Editor-at-Large for science news. Tim specializes in science, technology, environmental, business, and health journalism. He is additionally a practising microbiologist; and an author. He is also interested in history, politics and current affairs.

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