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首页> 外文期刊>BMJ: British medical journal >Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis
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Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis

机译：尼古丁替代的有效性和安全性减少治疗辅助戒烟:系统回顾和荟萃分析

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Objective To determine the effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking.Design Systematic review of randomised controlled trials. Data sources Cochrane Library, Medline, Embase, CINAHL, PsychlNFO, Science Citation Index, registries of ongoing trials, reference lists, the drug company that sponsored most of the trials, and clinical experts. Review methods Eligible studies were published or unpublished randomised controlled trials that enrolled smokers who declared no intention to quit smoking in the short term, and compared nicotine replacement therapy (with or without motivational support) with placebo, no treatment, other pharmacological therapy, or motivational support, and reported quit rates. Two reviewers independently applied eligibility criteria. One reviewer assessed study quality and extracted data and these processes were checked by a second reviewer. The primary outcome, six months sustained abstinence from smoking beginning during treatment, was assessed by individual patient data analysis. Other outcomes were cessation and reduction at end of follow-up, and adverse events. Data synthesis Seven placebo controlled randomised controlled trials were included (four used nicotine replacement therapy gum, two nicotine replacement therapy inhaler, and one free choice of therapy). They were reduction studies that reported smoking cessation as a secondary outcome. The trials enrolled a total of 2767 smokers, gave nicotine replacement therapy for 6-18 months, and lasted 12-26 months. 6.75% of smokers receiving nicotine replacement therapy attained sustained abstinence for six months, twice the rate of those receiving placebo (relative risk (fixed effects) 2.06, 95% confidence interval 1.34 to 3.15; (random effects) 1.99,1.01 to 3.91; five trials). The number needed to treat was 29. All other cessation and reduction outcomes were significantly more likely in smokers given nicotine replacement therapy than those given placebo. There were no statistically significant differences in adverse events (death, odds ratio 1.00, 95% confidence interval 0.25 to 4.02; serious adverse events, 1.16, 0.79 to 1.50; and discontinuation because of adverse events, 1.25, 0.64 to 2.51) except nausea, which was more common with nicotine replacement therapy (8.7% v 5.3%; odds ratio 1.69, 95% confidence interval 1.21 to 2.36). Conclusions Available trials indicate that nicotine' replacement therapy is an effective intervention in achieving sustained smoking abstinence for smokers who have no intention or are unable to attempt an abrupt quit. Most of the evidence, however, comes from trials with regular behavioural support and monitoring and it is unclear whether using nicotine replacement therapy without regular contact would be as effective.
机译：摘要目的确定有效性和尼古丁替代疗法辅助的安全减少戒烟。的随机对照试验。来源Cochrane图书馆、Medline和Embase,CINAHL PsychlNFO,科学引文索引,注册中心正在进行的试验,参考列表,制药公司赞助的试验和临床专家。合格的研究被发表或未发表的注册的随机对照试验吸烟者宣布不打算戒烟在短期内,而尼古丁替代疗法(有或没有动机支持)与安慰剂,没有治疗,其他药物疗法,或激励支持,和报告戒烟率。独立应用合格标准。评论家评估研究质量和提取数据和这些过程被第二次检查评论家。持续从吸烟开始禁欲在治疗期间,被个别评估病人数据分析。戒烟和减少后续末,和不良事件。控制的随机对照试验包括(四个使用尼古丁替代疗法口香糖,两个尼古丁替代疗法吸入器,和一个自由选择的治疗)。减少戒烟研究报道作为一个次要的结果。2767烟民,尼古丁替代治疗6 - 18个月,12-26持续了几个月。6.75%的吸烟者尼古丁替代治疗获得持续的禁欲了六个个月,那些接受安慰剂的两倍2.06(相对风险(固定效应),95%置信区间1.34 - 3.15;影响)1.99,1.01 - 3.91;数量需要治疗是29。戒烟和减少的结果明显更有可能吸烟尼古丁替代疗法比安慰剂。不良事件(死亡,比值比的差异1.00, 95%置信区间0.25 - 4.02;严重不良事件,1.16,0.79,1.50;中止,因为不良事件,1.25,0.64到2.51),除了恶心,更多与尼古丁替代疗法(8.7% v5.3%;1.21到2.36)。表明,尼古丁替代疗法是一个在实现持续有效的干预吸烟对吸烟者没有节制意图或突然无法尝试辞职。试验与常规行为支持和使用监控和目前尚不清楚尼古丁替代疗法没有固定接触会同样有效。

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