中国循证社会科学协作网

DOI

10.1111/ijcp.14594

The effects of pharmacological interventions on smoking cessation in people with alcohol dependence: A systematic review and meta-analysis of nine randomized controlled trials

Kangle Guo ; Jingwen Li ; Jieyun Li ; Nan Chen ; Yanfei Li ; Kehu Yang ; Xiuxia Li

作者地址

Health Technology Assessment Center/Evidence-based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

通讯作者

Kehu Yang; Xiuxia Li

来源期刊

International Journal of Clinical Practice

ISSN

1368-5031

EISSN

1742-1241

出版日期

2021-07-16

卷号

期号

摘要

Background Pharmacotherapies are widely used for smoking cessation. However, their efficacy for people with alcohol dependence remains unclear. Objective This study aimed to explore the effects of pharmacotherapies on smoking cessation for people with alcohol dependence. Methods Five electronic databases were searched in January 2021 for randomized controlled trials (RCTs) reporting the use of pharmacotherapies to promote smoking cessation in people with alcohol dependence. The risk of bias was assessed using the Cochrane tool. RevMan version 5.3 was used to perform meta-analyses of the changes in smoking behaviour, and the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of the evidence. Results The search identified nine RCTs involving 908 smokers with alcohol dependence; eight were published in the USA and one in Canada. The risk of bias was low in three studies and unclear in the remaining six. The meta-analysis results showed that, compared with the placebo group, Varenicline had a significant effect on short-term smoking cessation (three RCTs, odds ratio [OR] = 6.27, 95% confidence interval [CI]: [2.49, 15.78], P < .05, very low certainty). Naltrexone had no significant effect on smoking cessation in short-term or long-term observations (three RCTs, OR = 0.99, 95% CI: [0.54, 1.81], P = .97, moderate certainty), and Topiramate had no significant effects (two RCTs, OR = 1.56, 95% CI: [0.67, 3.46], P > .05, low certainty). Only one trial reported that Bupropion did not affect smoking cessation. Conclusion Varenicline may promote smoking cessation in people with alcohol dependence. However, Naltrexone, Topiramate and Bupropion have no clear effect on increasing smoking abstinence among drinkers. The small number of studies and the low certainty of evidence indicate that the results should be interpreted cautiously.

资助信息

Major Project of the National Social Science Fund of China: “Research on the Theoretical System, International Experience and Chinese Path of Evidence-based Social Science” (Project No. 19ZDA142) and the National Natural Science Foundation of China (Project No. 72074103)

资助机构

全国哲学社会科学工作办公室 ; 国家自然科学基金委

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