Pharmacological intervention on smoking cessation of drinking smokers: a
network meta-analysis of randomized controlled trials
Abstract
Background and Aim: Some clinical trials have reported on the treatment
of alcohol-drinking smokers with drugs. This network meta-analysis aims
to explore the effect of pharmacological interventions on smoking
cessation in such populations. Methods: Only randomized controlled
trials (RCTs) were included through a system and comprehensive database
search. The risk of bias for the included studies were assessed using
Cochrane tool. A network meta-analysis was performed using STATA
software to evaluate the effect size between different comparisons, and
provide the best smoking cessation intervention based on the SUCRA
value. Results: A total of 15 RCTs involving 1565 participants were
included. The risk of bias was low in five studies and unclear in ten
studies. Network meta-analysis showed that the superiority of quitting
smoking was reflected in Varenicline vs Placebo (OR=4.90, 95%CI
[1.77,13.55]), Varenicline vs Naltrexone (OR=3.50, 95%CI
[1.13,11.06]), and Varenicline vs Bupropion (OR=3.32, 95%CI
[1.03,10.74]). None of the other pairwise comparisons showed
significant difference. Finally, the probability ranking results
indicated that Varenicline was the most effective intervention.
Conclusions: The network meta-analysis showed that compared with
Naltrexone, Bupropion, and Placebo, Varenicline had obvious superiority
in quitting smoking, while there was no difference in effect between
other drugs. Meanwhile, we look forward to more high-quality studies to
investigate the existing evidence.