■几种药物干预措施,例如尼古丁替代疗法(NRT),伐尼克林,还有安非他酮,已被批准用于临床戒烟。电子烟(EC)在戒烟方面的潜力越来越多地被许多RCT所探索。此外,一些RCT正在尝试探索戒烟的新药,如金雀花碱。该网络荟萃分析(NMA)旨在研究这些药物和电子烟在疗效和可接受性方面的比较。
■本系统综述和NMA检索了2011年1月至2022年5月使用MEDLINE发表的所有关于使用药物单一疗法或电子烟戒烟的临床研究,COCHRANE图书馆,PsychINFO数据库。NRT按给药途径分为透皮(TDN)和口鼻尼古丁(ONN),因此,建立了7个网络节点进行直接和间接比较。两种不同的指标衡量了疗效:普遍禁烟和持续禁烟。脱落率衡量了可接受性。
■本研究中包括的最后40项临床研究包括77个研究队列和25,889名参与者。Varenicline是更有效的干预措施,在16-32周的随访期间协助戒烟,很可能会导致辍学。Cytisine在连续戒烟中显示出更高的有效性,但也可能导致戒烟。电子烟和口鼻尼古丁在鼓励普遍禁欲方面比没有治疗更有效,但最不可能促使辍学。最后,在持续禁欲的情况下,经皮尼古丁给药比不治疗更有效,对普遍禁欲和辍学率没有显著影响。
■本次审查建议并同意,Cytisine和透皮尼古丁给药,作为戒烟干预,有优点和缺点。然而,我们不得不对电子烟作为青少年戒烟的一种方式有所保留。
UNASSIGNED: Several pharmacological interventions, such as nicotine replacement therapy (NRT), varenicline, and bupropion, have been approved for clinical use of smoking cessation. E-cigarettes (EC) are increasingly explored by many RCTs for their potentiality in smoking cessation. In addition, some RCTs are attempting to explore new drugs for smoking cessation, such as cytisine. This network meta-analysis (NMA) aims to investigate how these drugs and e-cigarettes compare regarding their efficacy and acceptability.
UNASSIGNED: This systematic
review and NMA searched all clinical studies on smoking cessation using pharmacological monotherapies or e-cigarettes published from January 2011 to May 2022 using MEDLINE, COCHRANE Library, and PsychINFO databases. NRTs were divided into transdermal (TDN) and oronasal nicotine (ONN) by administrative routes, thus 7 network nodes were set up for direct and indirect comparison. Two different indicators measured the efficacy: prevalent and continuous smoking abstinence. The drop-out rates measured the acceptability.
UNASSIGNED: The final 40 clinical studies included in this study comprised 77 study cohorts and 25,889 participants. Varenicline is more effective intervention to assist in smoking cessation during 16-32 weeks follow-up, and is very likely to prompt dropout. Cytisine shows more effectiveness in continuous smoking cessation but may also lead to dropout. E-cigarettes and oronasal nicotine are more effective than no treatment in encouraging prevalent abstinence, but least likely to prompt dropout. Finally, transdermal nicotine delivery is more effective than no treatment in continuous abstinence, with neither significant effect on prevalent abstinence nor dropout rate.
UNASSIGNED: This
review suggested and agreed that Varenicline, Cytisine and transdermal nicotine delivery, as smoking cessation intervention, have advantages and disadvantages. However, we had to have reservations about e-cigarettes as a way to quit smoking in adolescents.