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February 1, 2020Health Technology AssessmentOpen Access

Varenicline versus nicotine replacement therapy for long-term smoking cessation: an observational study using the Clinical Practice Research Datalink

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Key result

Patients prescribed varenicline in primary care were more likely to be abstinent 6 months after treatment than those prescribed nicotine replacement therapy (OR 1.46).

Why the study?

Does varenicline improve smoking cessation rates compared to nicotine replacement therapy in adult smokers in primary care?

Population

220,136 smokers aged ≥ 18 years in the UK prescribed smoking cessation treatment after September 1, 2006.

Comparison

First prescription of varenicline vs Nicotine replacement therapy (NRT)

Design

Cohort

Follow-up

2 years (primary outcome), up to 4 years

Authors

NDNeil M DaviesATAmy E. TaylorGTGemma M. J. Taylor

Discussion

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Overview

Varenicline may be preferred over NRT for cessation in primary care; observational data leave open need for randomized confirmation.

Study Design

Type

Cohort (n=220,136)

Structured PICO

Does varenicline improve smoking cessation rates compared to nicotine replacement therapy in adult smokers in primary care?

P
Population
220,136 adults aged 18 years and older prescribed varenicline or nicotine replacement therapy for smoking cessation, followed for up to 4 years.
E
Exposure
First prescription of varenicline
C
Comparator
Nicotine replacement therapy (NRT)
O
Outcome
Smoking cessation 2 years after the first prescriptionpatient reported

Main Result

Odds Ratio: 1.46 (95% CI 1.42–1.5)

Varenicline is more effective than nicotine replacement therapy for smoking cessation in primary care, without evidence of increased mortality or morbidity.

Limitations

  • Not all code lists were validated
  • Body mass index and Index of Multiple Deprivation had missing values
  • Results may suffer from residual confounding
  • No information on treatment adherence

Cite This Study

Davies et al. (2020) conducted a cohort in Smoking (n=220,136). Varenicline vs. Nicotine replacement therapy was evaluated on Smoking cessation 6 months after treatment (OR 1.46, 95% CI 1.42 to 1.50). Patients prescribed varenicline in primary care were more likely to be abstinent 6 months after treatment than those prescribed nicotine replacement therapy (OR 1.46).

synapsesocial.com/papers/6ab73fc4d2c1437f300e431ehttps://doi.org/10.3310/hta24090
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The effects of prescribing varenicline on two‐year health outcomes: an observational cohort study using electronic medical records2018 · 16 citations
  2. 2Cardiovascular and neuropsychiatric risks of varenicline: a retrospective cohort study2015 · 104 citations
  3. 3Risk of neuropsychiatric and cardiovascular adverse events following treatment with varenicline and nicotine replacement therapy in the UK Clinical Practice Research Datalink: a case–cross‐over study2020 · 9 citations
  4. 4Efficacy and Adverse Effect of Varenicline (Champix) in Cessation of Smoking: Systematic Review2025 · 1 citations
  5. 5Comparison of Cardiovascular Safety for Smoking Cessation Pharmacotherapies in a Population-Based Cohort in Australia2021 · 7 citations