Combination of Varenicline with Nicotine Replacement Therapy for Smoking Cessation

Summary

A systematic review and meta-analysis 1 included 3 RCTs with 904 participants. Combination therapy of varenicline with nicotine replacement therapy (NRT) was better than varenicline alone at 3 months (OR 1.50, 95 % CI 1.14 to 1.97) and at 6 months (OR = 1.62, 95 % CI 1.18 to 2.23). However, this significance diminished after eliminating a study with pre-cessation treatment using nicotine patch.

In another systematic review and network meta-analysis 2 varenicline (standard dose) plus nicotine replacement therapy (standard dose) was ranked first for sustained abstinence (OR 5.75, 95% credible interval 2.27 to 14.90). Higher proportion of smokers who received counselling achieved sustained abstinence than those who did not receive counselling, and higher odds of sustained abstinence among participants with higher average dependence scores. The odds ratios for sustained abstinence wereNRT standard 2.01 (1.68 to 2.41), NRT high 2.32 (1.88 to 2.86), bupropion standard 1.73 (1.43 to 2.10), varenicline standard 2.83 (2.34 to 3.39), bupropion standard plus NRT high 1.99 (0.70 to 5.47), varenicline standard plus bupropion standard 3.25 (1.35 to 7.92).