Nicotine replacements help patients stop smoking, but some may be hard to get

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Quitting smoking is good for patient health and nicotine replacement therapies make it easier to stop.

A new meta-analysis found 14 in 100 people trying to quit smoking were more likely to succeed when using nicotine e-cigarettes, or the drugs varenicline or cytisine, which help reduce symptoms of nicotine withdrawal. When using two forms of NRT, about 12 in 100 will likely quit smoking, defined as no smoking for at least six months, according to a news release.

Using just one form of NRT, such as a nicotine patch or gum, had a success rate of about nine in 100, according to the study.

The bad news is that the drugs are not easily available at the moment.

Varenicline in its brand-name form, Champix, is not available in the United States and other parts of the world due to a manufacturing problem. However, generic forms of varenicline have been approved by the U.S. Food and Drug Administration.

Cytisine is not currently licensed or marketed outside countries of central and eastern Europe, according to the researchers.

“The best thing someone who smokes can do for their health is to quit smoking,” senior author Jamie Hartmann-Boyce said in a news release. Hartmann-Boyce is assistant professor of health policy and management in the School of Public Health and Health Sciences at the University of Massachusetts – Amherst.

“Our findings provide clear evidence of the effectiveness of nicotine e-cigarettes and combination nicotine replacement therapies to help people quit smoking,” Hartmann-Boyce said. “The evidence also is clear on the benefits of medicines cytisine and varenicline, but these may be harder for some people to access at the moment.”

The study examined results of stop-smoking aids used in 319 clinical trials with more than 150,000 people.

Tobacco smoking remains the leading preventable cause of death and disease worldwide. The trials in the review used regulated e-cigarettes with nicotine but without additional additives known to cause harm to smokers. Researchers don’t know the long-term effects of using nicotine e-cigarettes.

“Nicotine itself is not the thing that causes the many diseases we associate with smoking,” Hartmann-Boyce said. “Broad scientific consensus is that regulated nicotine e-cigarettes are highly, highly likely to be much less harmful than conventional cigarettes, but not harmless.”

The study, “Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses,” was published in Cochrane Database of Systematic Reviews.