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American Journal of Health-System Pharmacy, Vol. 64, Issue 23, 2471-2476
Copyright © 2007. American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/04/0602-1242$06.00


Clinical Report

Meta-analysis of studies investigating one-year effectiveness of transdermal nicotine patches for smoking cessation

Seung Kwon Myung, Keun-Young Yoo, Seung Won Oh, Seong Hi Park, Hong Gwan Seo, Seung Sik Hwang and Sue Kyung Park

SEUNG KWON MYUNG, M.D., is Clinical Physician, Smoking Cessation Clinic and Center for Cancer Prevention and Detection, National Cancer Center (NCC), Goyangsi, Republic of Korea. KEUN-YOUNG YOO, M.D., PH.D., is Professor, Department of Preventive Medicine, College of Medicine, Seoul National University (SNU), Seoul, Republic of Korea, and President, NCC. SEUNGW ONO H, M.D., is Clinical Professor, Department of Family Medicine, Konkuk University Hospital, Seoul. SEONGH I PARK, PH.D., is General Manager, Health Insurance Review and Assessment Service, Seoul. HONG GWAN SEO, M.D., PH.D., is Chairman, Smoking Cessation Clinic, and Clinical Physician, Center for Cancer Prevention and Detection, NCC. SEUNG SIKH WANG, M.D., PH.D., is Research Fellow, National Cancer Control Research Institute, NCC. SUE KYUNG PARK, M.D., PH.D., is Assistant Professor, Department of Preventive Medicine, College of Medicine, SNU.

Address correspondence to Dr. Yoo at the Department of Preventive Medicine, College of Medicine, Seoul National University, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Republic of Korea (kyyoo{at}plaza.snu.ac.kr).


Purpose. The one-year effectiveness of transdermal nicotine patches versus placebo patches for smoking cessation based on continuous or sustained abstinence was studied.

Methods. A literature search of MEDLINE (PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials up to April 2006 was conducted. Articles containing relevant keywords were reviewed by two evaluators independently. To be considered for inclusion in the meta-analysis, studies had to be randomized clinical trials with a transdermal nicotine patch group and a placebo patch group, had to include at least one year of follow-up, had to have abstinence biochemically verified, and had to include the odds ratio (OR) as an outcome measure.

Results. Sixteen trials met the selection criteria. The total number of subjects was 9457 (6084 in the nicotine patch group and 3373 in the placebo patch group). The pooled OR for smoking abstinence at one year for the nicotine patch group versus the placebo patch group was 1.79 (95% confidence interval [CI], 1.55–2.08). The pooled OR for one-year continuous or sustained abstinence for the nicotine patch compared with placebo, excluding four studies reporting only point-prevalence abstinence, was 1.75 (95% CI, 1.49–2.05).

Conclusion. A meta-analysis of trials of transdermal nicotine patch therapy versus placebo for smoking cessation yielded ORs for smoking abstinence of about 1.8 at one year after the start of therapy. ORs were similar whether the endpoint was point-prevalence abstinence, continuous or sustained abstinence, or both.

Index terms: Autonomic drugs; Nicotine; Patches transdermal; Smoking

 






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