A summary of all the Cochrane Reviews from 2021 to 2023 has been published in Addiction Journal by the Cochrane Tobacco Addiction Group (Cochrane TAG) and recommends vaping as one of its top 3 methods to quit smoking. As well as vaping, the authors of the report recommend Varenicline (a prescription drug sold under the brand names Chantix and Champix) and Cytisine (a plant-based compound available under prescription in the United Kingdom).
The authors (Livingstone-Banks, Lindson, and Hartmann-Boyce) say that the three methods work best when combined with behavioural support, such as counselling.
They add that Bupropion and nicotine replacement therapy (NRT) are also effective, especially NRT patches combined with fast acting forms like gum.
The paper states that there is strong evidence to support behavioural counselling and financial incentives for smoking cessation, even without additional medication.
The Cochrane Tobacco Addiction Group has provided systematic reviews of the highest quality for almost 30 years. This summary outlines the key findings from the fourteen Cochrane reviews that CTAG published between 2021 and 2023.
They state that three Cochrane reviews included in this summary are particularly noteworthy:
- The updated Cochrane review on nicotine replacement therapy (NRT) for smoking cessation found high-certainty evidence that combining a fast-acting form of NRT (gum, lozenges, sprays) with NRT patches helped more people to quit than single-form NRT alone.
- The Cochrane review of electronic cigarettes for smoking cessation is a living systematic review: review authors search for new studies monthly and update the review whenever new data emerge. The latest update concluded that there was high‐certainty evidence that e-cigarettes with nicotine increase quit rates compared with NRT and moderate‐certainty evidence that they increase quit rates compared with e-cigarettes without nicotine.
- The 2023 Cochrane review of pharmacological and e-cigarette interventions for smoking cessation included all drugs licensed as treatments for smoking cessation anywhere in the world, as well as e-cigarettes with or without nicotine. The review included 319 studies (157,179 participants). The most effective interventions were nicotine e‐cigarettes, varenicline and cytisine, all of which had high certainty evidence, closely followed by combination NRT (i.e. the use of a patch and fast-acting form of NRT together).
- The updated Cochrane review on nicotine receptor partial agonists (varenicline and cytisine) for smoking cessation found that, in studies directly comparing cytisine and varenicline, there may be no difference from either medication for quitting smoking. The review included 75 trials.
Lead author Dr Jonathan Livingstone-Banks says “Quitting smoking is difficult, and some people find it harder to quit than others, but tobacco is uniquely deadly among legal consumer products, so it’s important to seek help quitting. There’s a range of effective forms of support for smoking cessation, and cytisine, varenicline and e-cigarettes are all evidence-based ways to greatly increase people’s chances of successfully quitting smoking.”
Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, gambling, editorials, and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884.
References
- Livingstone-Banks J, Lindson N, and Hartmann-Boyce, J. Effects of interventions to combat tobacco addiction: Cochrane update of 2021 to 2023 reviews. Addiction. 2024. DOI: 10.1111/add.16624 - https://onlinelibrary.wiley.com/doi/10.1111/add.16624
Photo Credit:
Smoker photo by Sinitta Leunen on Unsplash
Dave Cross
Journalist at POTVDave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.