Respiratory Trials·org

Topic

Smoking cessation

Pharmacotherapy, e-cigarettes, and the cardiovascular safety question.

Stopping smoking is still the most effective thing in respiratory medicine. A cessation programme that succeeded in only one in five participants nonetheless reduced all-cause mortality over 14.5 years (Lung Health Study) — an effect no inhaler has approached.

E-cigarettes outperform nicotine replacement for one-year abstinence, 18.0% against 9.9%, when both are supported behaviourally (TEC). The finding usually quoted without its companion is that most successful quitters were still vaping at a year; whether that is durable harm reduction or substituted dependence, this trial cannot say.

Combining and extending pharmacotherapy

Trial Year Therapy Effect Finding
Baker 2021 2021 Varenicline plus nicotine patch Neither adding a nicotine patch to varenicline nor doubling the treatment duration helped

Combining nicotine products

Trial Year Therapy Effect Finding
Walker 2020 2020 Nicotine patch plus nicotine e-cigarette Adding a nicotine e-cigarette to patches gave a modest improvement in quitting

Does stopping smoking change mortality?

Trial Year Therapy Effect Finding
Lung Health Study 2005 Smoking cessation programme A cessation programme that worked for one in five participants still reduced all-cause mortality over 14.5 years

E-cigarettes for cessation

Trial Year Therapy Effect Finding
TEC 2019 E-cigarettes E-cigarettes nearly doubled one-year quit rates compared with nicotine replacement

Incentives and free products

Trial Year Therapy Effect Finding
Halpern 2018 2018 Financial incentives Only financial incentives worked; free cessation aids and free e-cigarettes alone did essentially nothing

Nicotine replacement

Trial Year Therapy Effect Finding
Transdermal Nicotine Study Group 1991 Transdermal nicotine patch Nicotine patches more than doubled short-term quit rates against placebo

Key references

Guidelines, standards and reviews for this topic.