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A systematic review of studies assessing the association between adherence to smoking cessation medication and treatment success

Raupach, T; Brown, J; Herbec, A; Brose, L; West, R; (2014) A systematic review of studies assessing the association between adherence to smoking cessation medication and treatment success. Addiction , 109 (1) 35 - 43. 10.1111/add.12319. Green open access

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Abstract

Aims: Lack of adherence to smoking cessation medication regimens is assumed to play a significant role in limiting their effectiveness. This study aimed to assess evidence for this assumption. / Methods: A systematic search was conducted, supplemented by expert consultation, of papers reporting on randomized trials and observational studies examining the association between adherence to cessation medication and the success of quit attempts. To rule out reverse causality, only studies where adherence was assessed prior to relapse were included. Five studies met the inclusion criteria and results were extracted independently by two researchers. Heterogeneity between studies precluded a pooled analysis of the data. / Results: Studies varied widely with regard to both the definition of adherence and outcome measures. The included studies only addressed adherence to nicotine replacement therapy. One study of lozenge use found that the amount of medication used between 1 and 2 weeks after the quit date predicted abstinence at 6 weeks [adjusted odds ratio (OR) for ‘high’ versus ‘low’ lozenge use 1.25; 95% confidence interval (CI) = 1.05–1.50; P < 0.02]. Similarly, one study found a significant impact of oral nicotine consumption during the first week on abstinence at 4 weeks (adjusted OR per additional mg/day = 1.05; CI = 1.01–1.10). Another study found that participants using nicotine replacement therapy for at least 5 weeks were significantly more likely to self-report continuous abstinence at 6 months. The remaining two studies failed to find a significant effect of treatment duration on outcome at 1 and 2 years but had very low power to detect such an effect. / Conclusions: There is modest evidence to support the assumption that lack of adherence to nicotine replacement therapy regimens undermines effectiveness in clinical studies.

Type: Article
Title: A systematic review of studies assessing the association between adherence to smoking cessation medication and treatment success
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/add.12319
Publisher version: http://dx.doi.org/10.1111/add.12319
Language: English
Additional information: This is the peer reviewed version of the following article: Raupach, T; Brown, J; Herbec, A; Brose, L; West, R; (2014) A systematic review of studies assessing the association between adherence to smoking cessation medication and treatment success. Addiction, 109 (1) 35 - 43, which has been published in final form at http://dx.doi.org/10.1111/add.12319. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms).
Keywords: Adherence, bupropion, cessation, compliance, medication, nicotine replacement therapy, quitting, smoking, success, varenicline
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/1404430
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