Cochrane · systematic review · CD006103
Nicotine receptor partial agonists for smoking cessation
Livingstone-Banks, J, Fanshawe, TR, Thomas, KH, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
32
current version
GRADE rated
21
No studies
6
Included studies
NR
No studies 6 · 18.8%Ungraded 5 · 15.6%Very low 2 · 6.3%Low 14 · 43.8%Moderate 2 · 6.3%High 3 · 9.4%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyVarenicline versus placebo or no medication for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs placebo or no medication | RR 2.32 [2.15, 2.51] | 41 studies · 17395 participants | High |
SAEs (varenicline vs placebo or no medication) Varenicline vs placebo or no medication | RR 1.23 [1.01, 1.48] | 26 studies · 14356 participants | Moderate Downgraded: imprecision, inconsistency |
Neuropsychiatric SAEs (varenicline vs placebo or no medication) Varenicline vs placebo or no medication | RR 0.89 [0.61, 1.29] | 22 studies · 7846 participants | Low Downgraded: imprecision, inconsistency |
Cardiac SAEs (varenicline vs placebo or no medication) Varenicline vs placebo or no medication | RR 1.2 [0.79, 1.84] | 18 studies · 7151 participants | Low Downgraded: imprecision, inconsistency |
Cytisine versus placebo or no medication for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Cytisine vs placebo or no medication | RR 1.3 [1.15, 1.47] | 4 studies · 4623 participants | Moderate Downgraded: imprecision, inconsistency |
SAEs (cytisine vs placebo or no medication) Cytisine vs placebo or no medication | RR 1.04 [0.78, 1.37] | 3 studies · 3781 participants | Low Downgraded: imprecision, inconsistency |
Neuropsychiatric SAEs (cytisine vs placebo or no medication) Cytisine vs placebo or no medication | no estimate extracted | NR | No studies |
Cardiac SAEs (cytisine vs placebo or no medication) Cytisine vs placebo or no medication | no estimate extracted | NR | No studies |
Cytisine versus varenicline for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Cytisine vs varenicline | RR 1 [0.79, 1.26] | 2 studies · 2131 participants | Low Downgraded: imprecision, inconsistency |
SAEs Cytisine vs varenicline | RR 0.67 [0.44, 1.03] | 2 studies · 2017 participants | Low Downgraded: imprecision, inconsistency |
Neuropsychiatric SAEs Cytisine vs varenicline | no estimate extracted | NR | No studies |
Cardiac SAEs Cytisine vs varenicline | no estimate extracted | NR | No studies |
Cytisine versus nicotine replacement therapy for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Cytisine vs nicotine replacement therapy | RR 1.43 [1.13, 1.8] | 1 study · 1310 participants | Low Downgraded: risk of bias, imprecision |
SAEs Cytisine vs nicotine replacement therapy | RR 1.15 [0.76, 1.75] | 1 study · 1310 participants | Very low Downgraded: risk of bias, imprecision |
Neuropsychiatric SAEs Cytisine vs nicotine replacement therapy | no estimate extracted | NR | No studies |
Cardiac SAEs Cytisine vs nicotine replacement therapy | no estimate extracted | NR | No studies |
Varenicline versus bupropion for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs bupropion | RR 1.36 [1.25, 1.49] | 9 studies · 7560 participants | High |
SAEs Varenicline vs bupropion | RR 0.89 [0.61, 1.31] | 5 studies · 5317 participants | Low Downgraded: imprecision |
Neuropsychiatric SAEs Varenicline vs bupropion | RR 1.05 [0.16, 7.04] | 2 studies · 866 participants | Low Downgraded: imprecision |
Cardiac SAEs Varenicline vs bupropion | RR 3.17 [0.33, 30.18] | 2 studies · 866 participants | Low Downgraded: imprecision |
Varenicline versus nicotine replacement therapy monotherapy for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs nicotine replacement therapy monotherapy | RR 1.25 [1.14, 1.37] | 11 studies · 7572 participants | High |
SAEs Varenicline vs nicotine replacement therapy monotherapy | RR 0.7 [0.5, 0.99] | 6 studies · 6535 participants | Low Downgraded: imprecision |
Neuropsychiatric SAEs Varenicline vs nicotine replacement therapy monotherapy | no estimate extracted | 1 study · 137 participants | Ungraded |
Cardiac SAEs Varenicline vs nicotine replacement therapy monotherapy | no estimate extracted | 1 study · 137 participants | Ungraded |
Varenicline versus combination nicotine replacement therapy for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs combination nicotine replacement therapy | RR 1.02 [0.87, 1.2] | 5 studies · 2344 participants | Low Downgraded: imprecision |
SAEs Varenicline vs combination nicotine replacement therapy | RR 2.15 [0.49, 9.46] | 4 studies · 1852 participants | Low Downgraded: imprecision |
Neuropsychiatric SAEs Varenicline vs combination nicotine replacement therapy | RR 4.69 [0.23, 96.5] | 2 studies · 764 participants | Low Downgraded: imprecision |
Cardiac SAEs Varenicline vs combination nicotine replacement therapy | RR 0.32 [0.01, 7.88] | 2 studies · 819 participants | Low Downgraded: imprecision |
Varenicline versus e‐cigarettes for smoking cessation
Population: people who continued to smoke tobacco following acute coronary syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs e‐cigarettes | RR 3.25 [1.21, 8.71] | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
SAEs Varenicline vs e‐cigarettes | no estimate extracted | 1 study · 54 participants | Ungraded |
Neuropsychiatric SAEs Varenicline vs e‐cigarettes | no estimate extracted | 1 study · 54 participants | Ungraded |
Cardiac SAEs Varenicline vs e‐cigarettes | no estimate extracted | 1 study · 54 participants | Ungraded |
Varenicline versus placebo or no medication for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs placebo or no medication | RR 2.32 [2.15, 2.51] | 41 studies · 17395 participants | High |
SAEs (varenicline vs placebo or no medication) Varenicline vs placebo or no medication | RR 1.23 [1.01, 1.48] | 26 studies · 14356 participants | Moderate Downgraded: imprecision, inconsistency |
Neuropsychiatric SAEs (varenicline vs placebo or no medication) Varenicline vs placebo or no medication | RR 0.89 [0.61, 1.29] | 22 studies · 7846 participants | Low Downgraded: imprecision, inconsistency |
Cardiac SAEs (varenicline vs placebo or no medication) Varenicline vs placebo or no medication | RR 1.2 [0.79, 1.84] | 18 studies · 7151 participants | Low Downgraded: imprecision, inconsistency |
Cytisine versus placebo or no medication for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Cytisine vs placebo or no medication | RR 1.3 [1.15, 1.47] | 4 studies · 4623 participants | Moderate Downgraded: imprecision, inconsistency |
SAEs (cytisine vs placebo or no medication) Cytisine vs placebo or no medication | RR 1.04 [0.78, 1.37] | 3 studies · 3781 participants | Low Downgraded: imprecision, inconsistency |
Neuropsychiatric SAEs (cytisine vs placebo or no medication) Cytisine vs placebo or no medication | no estimate extracted | NR | No studies |
Cardiac SAEs (cytisine vs placebo or no medication) Cytisine vs placebo or no medication | no estimate extracted | NR | No studies |
Cytisine versus varenicline for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Cytisine vs varenicline | RR 0.83 [0.66, 1.05] | 2 studies · 2131 participants | Moderate Downgraded: imprecision |
SAEs Cytisine vs varenicline | RR 0.67 [0.44, 1.03] | 2 studies · 2017 participants | Low Downgraded: imprecision |
Neuropsychiatric SAEs Cytisine vs varenicline | no estimate extracted | NR | No studies |
Cardiac SAEs Cytisine vs varenicline | no estimate extracted | NR | No studies |
Cytisine versus nicotine replacement therapy for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Cytisine vs nicotine replacement therapy | RR 1.43 [1.13, 1.8] | 1 study · 1310 participants | Low Downgraded: risk of bias, imprecision |
SAEs Cytisine vs nicotine replacement therapy | RR 1.15 [0.76, 1.75] | 1 study · 1310 participants | Very low Downgraded: risk of bias, imprecision |
Neuropsychiatric SAEs Cytisine vs nicotine replacement therapy | no estimate extracted | NR | No studies |
Cardiac SAEs Cytisine vs nicotine replacement therapy | no estimate extracted | NR | No studies |
Varenicline versus bupropion for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs bupropion | RR 1.36 [1.25, 1.49] | 9 studies · 7560 participants | High |
SAEs Varenicline vs bupropion | RR 0.89 [0.61, 1.31] | 5 studies · 5317 participants | Low Downgraded: imprecision |
Neuropsychiatric SAEs Varenicline vs bupropion | RR 1.05 [0.16, 7.04] | 2 studies · 866 participants | Low Downgraded: imprecision |
Cardiac SAEs Varenicline vs bupropion | RR 3.17 [0.33, 30.18] | 2 studies · 866 participants | Low Downgraded: imprecision |
Varenicline versus nicotine replacement therapy monotherapy for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs nicotine replacement therapy monotherapy | RR 1.25 [1.14, 1.37] | 11 studies · 7572 participants | High |
SAEs Varenicline vs nicotine replacement therapy monotherapy | RR 0.7 [0.5, 0.99] | 6 studies · 6535 participants | Low Downgraded: imprecision |
Neuropsychiatric SAEs Varenicline vs nicotine replacement therapy monotherapy | no estimate extracted | 1 study · 137 participants | Ungraded |
Cardiac SAEs Varenicline vs nicotine replacement therapy monotherapy | no estimate extracted | 1 study · 137 participants | Ungraded |
Varenicline versus combination nicotine replacement therapy for smoking cessation
Population: people who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs combination nicotine replacement therapy | RR 1.02 [0.87, 1.2] | 5 studies · 2344 participants | Low Downgraded: imprecision |
SAEs Varenicline vs combination nicotine replacement therapy | RR 2.15 [0.49, 9.46] | 4 studies · 1852 participants | Low Downgraded: imprecision |
Neuropsychiatric SAEs Varenicline vs combination nicotine replacement therapy | RR 4.69 [0.23, 96.5] | 2 studies · 764 participants | Low Downgraded: imprecision |
Cardiac SAEs Varenicline vs combination nicotine replacement therapy | RR 0.32 [0.01, 7.88] | 2 studies · 819 participants | Low Downgraded: imprecision |
Varenicline versus e‐cigarettes for smoking cessation
Population: people who continued to smoke tobacco following acute coronary syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Smoking abstinence at longest Varenicline vs e‐cigarettes | RR 3.25 [1.21, 8.71] | 1 study · 54 participants | Very low Downgraded: risk of bias, imprecision |
SAEs Varenicline vs e‐cigarettes | no estimate extracted | 1 study · 54 participants | Ungraded |
Neuropsychiatric SAEs Varenicline vs e‐cigarettes | no estimate extracted | 1 study · 54 participants | Ungraded |
Cardiac SAEs Varenicline vs e‐cigarettes | no estimate extracted | 1 study · 54 participants | Ungraded |
Nicotine receptor partial agonists for smoking cessation
Population: Individuals who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Varenicline vs placebo: continuous/sustained abstinence at longest | RR 2.24 [2.06, 2.43] | 27 studies · 12625 participants | High |
Varenicline vs bupropion: continuous/sustained abstinence (24 weeks) | RR 1.39 [1.25, 1.54] | 5 studies · 5877 participants | High |
Varenicline vs NRT: point prevalence abstinence (24 weeks) | RR 1.25 [1.14, 1.37] | 8 studies · 6264 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Varenicline vs placebo: number of participants reporting SAEs in duration of trials (trials reporting no events in either group excluded) | RR 1.25 [1.04, 1.49] | 29 studies · 15370 participants | High |
Varenicline vs placebo: number of participants reporting cardiac SAEs, including deaths, in duration of trials | RR 1.36 [0.91, 2.04] | 21 studies · 8587 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Varenicline vs placebo: number of participants reporting nausea in duration of trials | RR 3.27 [3, 3.55] | 32 studies · 14963 participants | High |
Nicotine receptor partial agonists for smoking cessation
Population: Individuals who smoke tobacco
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cytisine vs placebo: continuous abstinence at longest | RR 3.98 [2.01, 7.87] | 2 studies · 937 participants | Low Downgraded: imprecision |