National Centre for Smoking Cessation and Training and Department of Clinical, Educational, and Health Psychology, University College London, London, England.
Mayo Clin Proc. 2013 Mar;88(3):226-33. doi: 10.1016/j.mayocp.2012.11.013. Epub 2013 Feb 27.
To compare the effectiveness of varenicline and combination nicotine replacement therapy (NRT) for treating smokers attempting to stop, as it is unclear which of the 2 is more effective.
Data from 167,487 treatment episodes in patients from 42 National Health Service Stop Smoking Services (April 1, 2009, through June 30, 2011) using varenicline or combination NRT were analyzed. The outcome was carbon monoxide-validated 4-week smoking abstinence. Potential predictors were age, sex, occupational grade, exemption from prescription charges, intervention setting (specialist or other), support (group or other), and year of quit attempt.
Observed smoking abstinence rates were higher with varenicline (43.5% vs 36.9%). However, there was evidence of systematic variation in medication effect across clinical services and differences in predictors of outcome between medications. Allowing for these influences indicated a small mean advantage for varenicline (odds ratio, 1.080; 95% CI, 1.003-1.163; difference, 1.86%; 95% CI, 0.07%-3.67%; P=.04). The relative effectiveness of the 2 medications was not moderated by setting, type of support, or year.
The relative effect of medication varies substantially according to clinical practice and population treated. Averaged across current English clinical practice and populations, varenicline is marginally more effective than combination NRT. Demographic and intervention characteristics associated with success predict varenicline use.
比较伐尼克兰和尼古丁替代疗法（NRT）联合治疗戒烟者的效果，因为不清楚这两种药物哪种更有效。
分析了来自 42 个英国国家卫生服务戒烟服务中心（2009 年 4 月 1 日至 2011 年 6 月 30 日）的 167487 个治疗疗程中使用伐尼克兰或尼古丁替代疗法联合治疗的患者数据。结果是通过一氧化碳验证的 4 周戒烟成功率。潜在的预测因素包括年龄、性别、职业等级、是否免除处方费、干预场所（专科或其他）、支持（小组或其他）以及戒烟尝试的年份。
使用伐尼克兰的观察性戒烟成功率更高（43.5%比 36.9%）。然而，药物效果在临床服务中存在系统差异，而且药物之间的结果预测因素存在差异。考虑到这些影响，伐尼克兰有小的平均优势（比值比，1.080；95%置信区间，1.003-1.163；差异，1.86%；95%置信区间，0.07%-3.67%；P=0.04）。两种药物的相对有效性不受设置、支持类型或年份的影响。
药物的相对效果根据临床实践和治疗人群有很大差异。在当前英国的临床实践和人群中平均来看，伐尼克兰比尼古丁替代疗法联合治疗略有效。与成功相关的人口统计学和干预特征预测了伐尼克兰的使用。
