True or False poll no. 62
Canadian Agency for Drugs and Technologies in Health (CADTH)
To quit smoking, nicotine replacement therapy is the most effective drug aid.
FALSE
In 2010, a major CADTH review showed that varenicline is, on average, more effective than nicotine replacement therapy (NRT) — but for some patients, NRT might still be the preferred choice for other reasons, such as convenience. (These findings were still valid after CADTH reviewed new evidence in 2016.)
The three primary drug aids for smoking cessation are NRT, bupropion and varenicline. NRT is often assumed to be the most effective of the three because of its common usage. It is available without prescription in forms such as patch or gum, and it does work for many people — the review found that NRT generally doubles the chance of quitting. Bupropion, a prescription antidepressant, was also found to double the chances of quitting. However, varenicline, which blocks the nicotine receptors in the brain, came out on top, doubling or tripling the chances of quitting.
However, it is important to consider that each drug class has associated advantages and disadvantages, including side effects such as headaches and insomnia. Varenicline caused more weight gain at 12 weeks than bupropion (but less than with placebo). The 2016 CADTH review found several studies that showed no effect for NRT, but these studies were generally small and conducted in specific groups of people (e.g., adolescents, people using smokeless tobacco, or recent quitters who were attempting to prevent relapse). For the general population, all three drug aids for smoking cessation are effective, and patient preference can drive prescribing.
For more information, visit www.cadth.ca/smokingcessation