A Cochrane review included 16 studies with a total of 13 123 subjects with chronic obstructive pulmonary disease (COPD). Nicotine sublingual tablet and varenicline (both high quality evidence), bupropion (moderate quality evidence), and nortriptyline (low quality evidence) increased the quit rate over placebo (table ). There was high-quality evidence for the effectiveness of pharmacotherapy plus high-intensity behavioural treatment compared with placebo plus high-intensity behavioural treatment (RR 2.53, 95% CI 1.83 to 3.50). Furthermore, high-intensity behavioural treatment increased abstinence rates when compared with usual care (RR 25.38, 95% CI 8.03 to 80.22, moderate quality evidence) or low-intensity behavioural treatment (RR 2.18, 95% CI 1.05 to 4.49). Finally, the results showed effectiveness of various combinations of psychosocial and pharmacological interventions.
| Outcome: Prolonged abstinence at longest follow-up | Relative effect (95% CI) | Assumed risk - Placebo | Corresponding risk - Pharmacological treatment (95% CI) | No of Participants (studies) |
|---|---|---|---|---|
| All drug treatment: Follow-up 6 to 12 months (mo) | RR 2.53 (95% CI 1.83, 3.50) | 66 / 1000 | 168 / 1000 (136 to 207) | 1429 (4) |
| Nicotine replacement therapy: Follow-up: 12 mo | RR 2.60 (95% CI 1.29, 5.24) | 54 / 1000 | 141 / 1000 (70 to 283) | 370 (1) |
| Varenicline: Follow-up:12 mo | RR 3.34 (95% CI 1.88, 5.92) | 55 / 1000 | 184 / 1000 (104 to 326) | 504 (1) |
| Bupropion: Follow-up: 6 mo | RR 2.03 (95% CI 1.26, 3.28) | 87 / 1000 | 177 / 1000 (110 to 285) | 503 (2) |
| Nortriptyline: Follow-up: 6 mo | RR 2.54 (95% CI 0.87, 7.44) | 83 / 1000 | 212 / 1000 (72 to 620) | 100 (1) |
Date of latest search: 22 March 2016