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Auteur Nicola Lindson |
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Titre : Effects of interventions to combat tobacco addiction : Cochrane update of 2021 to 2023 reviews Type de document : document électronique Auteurs : Jonathan Livingstone-Banks, Auteur ; Nicola Lindson, Auteur ; Jamie Hartmann-Boyce, Auteur Editeur : Society for the study of addiction to alcohol and other drugs Année de publication : 2024 Collection : Addiction num. 119(12) Importance : p. 2101-2115 Présentation : tab. Langues : Anglais (eng) Catégories : [TABAC] chimie du tabac:tabac fumé:cigarette:cigarette électronique
[TABAC] sevrage tabagique:efficacité du sevrage
[TABAC] sevrage tabagique:méthode de sevrage:méthode individuelle:approche pharmacologique:substitution nicotinique
[TABAC] tabagisme:aspect économiqueIndex. décimale : TA 6.2.3 Approche pharmacologique Résumé : Aims: To summarise systematic reviews on tobacco addiction published by the Cochrane Tobacco Addiction Group (CTAG) from 2021 to 2023.
Methods: We identified all new and updated Cochrane Reviews published by CTAG
between 2021 and 2023. We present key results from these reviews and discuss promising avenues for future research.
Results: CTAG published five new reviews and one overview of reviews, and updated eight reviews. Review evidence showed that all main pharmacotherapies (varenicline, cytisine, bupropion and nicotine replacement therapy [NRT], especially when patches
are combined with fast acting forms like gum) are effective for smoking cessation, as are nicotine e-cigarettes. Evidence suggested similar magnitude of effects of varenicline,
cytisine, and nicotine e-cigarettes; these emerged as the most effective treatments. Evidence also supported behavioural counselling and financial incentives for smoking cessation. Secondary analyses of the Cochrane review of e-cigarettes for smoking cessation showed over half of participants assigned to e-cigarette conditions were still using them
at six months or longer, that biomarkers of potential harm significantly reduced in people switching from smoking to vaping or to dual use, and that there was insufficient evidence to draw associations between e-liquid flavours and smoking cessation. Findings on mindfulness-based interventions, interventions delivered by dental and primary care professionals, interventions to prevent weight gain after smoking cessation, and interventions for waterpipe cessation were less certain. Reviews of observational evidence showed that smoking cessation reduced cardiovascular events and mortality in people living with cardiovascular disease, and improved mental health.
Conclusions: Nicotine replacement therapy (especially patches combined with fast acting forms), varenicline, cytisine, bupropion, nicotine e-cigarettes, behavioural counselling, and financial incentives are all effective ways to help people quit smoking. Quitting smoking improves mental health and reduces cardiovascular events and mortality in people living with cardiovascular disease.En ligne : https://doi.org/10.1111/add.16624 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10456 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Electronic cigarettes for smoking cessation (Review) Type de document : document électronique Auteurs : Nicola Lindson, Auteur ; AR Butler, Auteur ; Hayden McRobbie, Auteur Editeur : The Cochrane Collaboration Année de publication : 2025 Collection : Cochrane Database of Systematic Reviews num. 1 Importance : 363 p. Note générale : Le full text de 363 p. est disponible en ligne.
En pièce jointe se trouve un résumé.Langues : Anglais (eng) Catégories : [TABAC] chimie du tabac:constituant:alcaloïde:nicotine
[TABAC] chimie du tabac:tabac fumé:cigarette:cigarette électronique
[TABAC] sevrage tabagique
[TABAC] sevrage tabagique:méthode de sevrage:méthode individuelle:approche pharmacologique:effet secondaireIndex. décimale : TA 6.2.3.2 Autres produits Résumé : Background
Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol by heating an e‐liquid. People who smoke, healthcare providers and regulators want to know if ECs can help people quit smoking, and if they are safe to use for this purpose. This is a review update conducted as part of a living systematic review.
Objectives
To examine the safety, tolerability and effectiveness of using electronic cigarettes (ECs) to help people who smoke tobacco achieve long‐term smoking abstinence, in comparison to non‐nicotine EC, other smoking cessation treatments and no treatment.
Search methods
We searched the Cochrane Tobacco Addiction Group's Specialized Register to 1 February 2023, and Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO to 1 July 2023, and reference‐checked and contacted study authors.
Selection criteria
We included trials in which people who smoke were randomized to an EC or control condition. We also included uncontrolled intervention studies in which all participants received an EC intervention as these studies have the potential to provide further information on harms and longer‐term use. Studies had to report an eligible outcome.
Data collection and analysis
We followed standard Cochrane methods for screening and data extraction. Critical outcomes were abstinence from smoking after at least six months, adverse events (AEs), and serious adverse events (SAEs). We used a fixed‐effect Mantel‐Haenszel model to calculate risk ratios (RRs) with a 95% confidence interval (CI) for dichotomous outcomes. For continuous outcomes, we calculated mean differences. Where appropriate, we pooled data in pairwise and network meta‐analyses (NMA).
Main results
We included 88 completed studies (10 new to this update), representing 27,235 participants, of which 47 were randomized controlled trials (RCTs). Of the included studies, we rated ten (all but one contributing to our main comparisons) at low risk of bias overall, 58 at high risk overall (including all non‐randomized studies), and the remainder at unclear risk.
There is high certainty that nicotine EC increases quit rates compared to nicotine replacement therapy (NRT) (RR 1.59, 95% CI 1.29 to 1.93; I2 = 0%; 7 studies, 2544 participants). In absolute terms, this might translate to an additional four quitters per 100 (95% CI 2 to 6 more). There is moderate‐certainty evidence (limited by imprecision) that the rate of occurrence of AEs is similar between groups (RR 1.03, 95% CI 0.91 to 1.17; I2 = 0%; 5 studies, 2052 participants). SAEs were rare, and there is insufficient evidence to determine whether rates differ between groups due to very serious imprecision (RR 1.20, 95% CI 0.90 to 1.60; I2 = 32%; 6 studies, 2761 participants; low‐certainty evidence).
There is moderate‐certainty evidence, limited by imprecision, that nicotine EC increases quit rates compared to non‐nicotine EC (RR 1.46, 95% CI 1.09 to 1.96; I2 = 4%; 6 studies, 1613 participants). In absolute terms, this might lead to an additional three quitters per 100 (95% CI 1 to 7 more). There is moderate‐certainty evidence of no difference in the rate of AEs between these groups (RR 1.01, 95% CI 0.91 to 1.11; I2 = 0%; 5 studies, 1840 participants). There is insufficient evidence to determine whether rates of SAEs differ between groups, due to very serious imprecision (RR 1.00, 95% CI 0.56 to 1.79; I2 = 0%; 9 studies, 1412 participants; low‐certainty evidence).
Due to issues with risk of bias, there is low‐certainty evidence that, compared to behavioural support only/no support, quit rates may be higher for participants randomized to nicotine EC (RR 1.88, 95% CI 1.56 to 2.25; I2 = 0%; 9 studies, 5024 participants). In absolute terms, this represents an additional four quitters per 100 (95% CI 2 to 5 more). There was some evidence that (non‐serious) AEs may be more common in people randomized to nicotine EC (RR 1.22, 95% CI 1.12 to 1.32; I2 = 41%, low‐certainty evidence; 4 studies, 765 participants) and, again, insufficient evidence to determine whether rates of SAEs differed between groups (RR 0.89, 95% CI 0.59 to 1.34; I2 = 23%; 10 studies, 3263 participants; very low‐certainty evidence).
Results from the NMA were consistent with those from pairwise meta‐analyses for all critical outcomes, and there was no indication of inconsistency within the networks.
Data from non‐randomized studies were consistent with RCT data. The most commonly reported AEs were throat/mouth irritation, headache, cough, and nausea, which tended to dissipate with continued EC use. Very few studies reported data on other outcomes or comparisons, hence, evidence for these is limited, with CIs often encompassing both clinically significant harm and benefit.
Authors' conclusions
There is high‐certainty evidence that ECs with nicotine increase quit rates compared to NRT and moderate‐certainty evidence that they increase quit rates compared to ECs without nicotine. Evidence comparing nicotine EC with usual care/no treatment also suggests benefit, but is less certain due to risk of bias inherent in the study design. Confidence intervals were for the most part wide for data on AEs, SAEs and other safety markers, with no difference in AEs between nicotine and non‐nicotine ECs nor between nicotine ECs and NRT. Overall incidence of SAEs was low across all study arms. We did not detect evidence of serious harm from nicotine EC, but the longest follow‐up was two years and the number of studies was small.
The main limitation of the evidence base remains imprecision due to the small number of RCTs, often with low event rates. Further RCTs are underway. To ensure the review continues to provide up‐to‐date information to decision‐makers, this review is a living systematic review. We run searches monthly, with the review updated when relevant new evidence becomes available. Please refer to the Cochrane Database of Systematic Reviews for the review's current status.En ligne : https://doi.org/10.1002/14651858.CD010216.pub9 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10547 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Titre : Motivational interviewing for smoking cessation (review) Type de document : document électronique Auteurs : Nicola Lindson, Auteur ; Tom P. Thompson, Auteur ; Anne Ferrey, Auteur ; Jeffrey D. Lambert, Auteur ; Paul Aveyard, Auteur Editeur : The Cochrane Collaboration Année de publication : 2019 Collection : Cochrane Database of Systematic Reviews num. Issue 7 Importance : i, i, 126 p. Langues : Anglais (eng) Catégories : [TABAC] sevrage tabagique:efficacité du sevrage
[TABAC] sevrage tabagique:méthode de sevrage:méthode individuelle:approche psychologique:entretien motivationnelIndex. décimale : TA 6.2.2 Approche psychologique (y compris entretien motivationnel) Résumé : Les entretiens motivationnels (EM) sont des conseils directifs axés sur le patient, destinés à lui permettre d'explorer et de résoudre une ambivalence concernant le changement de son comportement. Cette approche a été développée comme traitement pour l'abus d'alcool, mais peut aider les gens à faire une tentative réussie d'arrêter de fumer.
Les objectifs de cette review sont d'évaluer l'efficacité de l'EM dans le sevrage tabagique par rapport à l'absence de traitement, en plus d'une autre forme de traitement de sevrage tabagique, et par rapport à d'autres types de traitement. Nous avons également cherché à savoir si des EM plus intensifs sont plus efficace que l’EM moins intensif pour l'abandon du tabac.
En ligne : https://doi.org/10.1002/14651858.CD006936.pub4 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10009 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses (Review) / Nicola Lindson (2023)
Titre : Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses (Review) : a randomized clinical trial Type de document : document électronique Auteurs : Nicola Lindson, Auteur ; A. Theodoulou, Auteur ; José Ordóñez-Mena, Auteur Editeur : The Cochrane Collaboration Année de publication : 2023 Collection : Cochrane Database of Systematic Reviews Importance : 42 p. Présentation : ill. ; graph. ; tab. Langues : Anglais (eng) Catégories : [DIVERS] personne:par âge:adulte
[TABAC] chimie du tabac:tabac fumé:cigarette:cigarette électronique
[TABAC] étude:méta-analyse
[TABAC] sevrage tabagique:effet du sevrage:bénéfice du sevrage tabagique
[TABAC] sevrage tabagique:méthode de sevrage:méthode individuelle:approche pharmacologique:substitution nicotinique
[TABAC] tabagisme:effet du tabacIndex. décimale : TA 6.2.3 Approche pharmacologique Résumé : Objectives
To investigate the comparative benefits, harms and tolerability of different smoking cessation pharmacotherapies and e‐cigarettes, when used to help people stop smoking tobacco.
[...]
Main results
Of our 332 eligible RCTs, 319 (835 study arms, 157,179 participants) provided sufficient data to be included in our cNMA. Of these, we judged 51 to be at low risk of bias overall, 104 at high risk and 164 at unclear risk, and 118 reported pharmaceutical or e‐cigarette/tobacco industry funding. Removing studies at high risk of bias did not change our interpretation of the results.
[...]
Authors' conclusions
The most effective interventions were nicotine e‐cigarettes, varenicline and cytisine (all high certainty), as well as combination NRT (additive effect, certainty not rated). There was also high‐certainty evidence for the effectiveness of nicotine patch, fast‐acting NRT and bupropion. Less certain evidence of benefit was present for nortriptyline (moderate certainty), non‐nicotine e‐cigarettes and tapering of nicotine dose (both low certainty).
There was moderate‐certainty evidence that bupropion may slightly increase the frequency of SAEs, although there was also the possibility of no increased risk. There was no clear evidence that any other tested interventions increased SAEs. Overall, SAE data were sparse with very low numbers of SAEs, and so further evidence may change our interpretation and certainty.
Future studies should report SAEs to strengthen certainty in this outcome. More head‐to‐head comparisons of the most effective interventions are needed, as are tests of combinations of these. Future work should unify data from behavioural and pharmacological interventions to inform approaches to combined support for smoking cessation.En ligne : https://doi.org/10.1002/14651858.CD015226.pub2 Format de la ressource électronique : Article en ligne Permalink : https://biblio.fares.be/opac_css/index.php?lvl=notice_display&id=10732 Aucun avis, veuillez vous identifier pour ajouter le vôtre !
