Centre for Tobacco-Dependence of the 3rd Medical Department-Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague, Praha 2, Czech Republic.
Addiction. 2013 Aug;108(8):1497-502. doi: 10.1111/add.12219. Epub 2013 May 13.
Cross-study comparisons of effect sizes suggest that varenicline is more effective than nicotine replacement therapy (NRT) in aiding smoking cessation, but evidence from direct comparisons is limited. This study compared biochemically verified 52-week sustained abstinence rates in smokers attending the same clinical service according to whether they used varenicline or NRT in their quit attempt.
This was a prospective cohort study of 855 smokers attending a large smoking cessation clinic who used their choice of NRT product or varenicline in their quit attempt. All received the same behavioural support programme and chose their medication option (n = 519 varenicline; n = 336 NRT). The primary outcome measure was self-report of 52 weeks' abstinence following the target quit date confirmed by expired air carbon monoxide concentration. Baseline measures included socio-demographic variables, mental health diagnoses, measures of smoking, cigarette dependence and past use of NRT or varenicline.
The 52-week abstinence rates were 42.8% versus 31.0% in those using varenicline versus NRT, respectively (P < 0.001). After adjusting for all baseline variables, the odds of remaining abstinent for 52 weeks were 2.03 (95% CI 1.46-2.82), P < 0.001 times higher in those using varenicline than those using NRT.
Smokers in the same behavioural support programme who use varenicline appear to have a greater probability of achieving long-term abstinence than those using their choice of nicotine replacement therapy options, even after adjusting for potentially confounding smoker characteristics.
跨研究的效应量比较表明，伐尼克兰在帮助戒烟方面比尼古丁替代疗法（NRT）更有效，但来自直接比较的证据有限。本研究根据在同一临床服务机构就诊的吸烟者在戒烟尝试中使用伐尼克兰或 NRT 的情况，比较了他们在 52 周时生物化学验证的持续戒烟率。
这是一项前瞻性队列研究，共纳入 855 名在大型戒烟诊所就诊的吸烟者，他们在戒烟尝试中使用了自己选择的 NRT 产品或伐尼克兰。所有患者均接受了相同的行为支持方案，并选择了自己的药物治疗方案（n=519 例伐尼克兰；n=336 例 NRT）。主要结局测量指标为目标戒烟日期后 52 周的自我报告戒烟率，通过呼出一氧化碳浓度来确认。基线测量指标包括社会人口统计学变量、心理健康诊断、吸烟、香烟依赖以及过去使用 NRT 或伐尼克兰的情况。
使用伐尼克兰和 NRT 的患者在第 52 周的戒烟率分别为 42.8%和 31.0%（P<0.001）。在校正所有基线变量后，使用伐尼克兰的患者在第 52 周保持戒烟的几率比使用 NRT 的患者高 2.03 倍（95%CI 1.46-2.82），P<0.001。
在同一行为支持方案中，使用伐尼克兰的吸烟者似乎比使用其选择的尼古丁替代疗法更有可能实现长期戒烟，即使在校正了可能存在混杂因素的吸烟者特征后也是如此。
