Abstract
Background
and Aim: Some clinical trials have reported on the treatment of
alcohol-drinking smokers with drugs.
This network meta-analysis aims to explore the effect of pharmacological
interventions on smoking cessation in such populations.
Methods: Only randomized controlled trials (RCTs) were included
through a system and comprehensive database search. The risk of bias for
the included studies were assessed using Cochrane tool. A network
meta-analysis was performed using STATA software to evaluate the effect
size between different comparisons, and provide the best smoking
cessation intervention based on the SUCRA value.
Results: A total of 15 RCTs involving 1565 participants were
included. The risk of bias was low in five studies and unclear in ten
studies. Network meta-analysis showed that the superiority of quitting
smoking was reflected in Varenicline vs Placebo (OR=4.90, 95%CI
[1.77,13.55]), Varenicline vs Naltrexone (OR=3.50, 95%CI
[1.13,11.06]), and Varenicline vs Bupropion (OR=3.32, 95%CI
[1.03,10.74]). None of the other pairwise comparisons showed
significant difference. Finally, the probability ranking results
indicated that Varenicline was the most effective intervention.
Conclusions: The network meta-analysis showed that compared
with Naltrexone, Bupropion, and Placebo, Varenicline had obvious
superiority in quitting smoking, while there was no difference in effect
between other drugs. Meanwhile, we look forward to more high-quality
studies to investigate the existing evidence.
Keywords: Pharmacotherapies, Smoking cessation, Drinking
smokers, Network meta-analysis