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'Cut down to quit' with nicotine replacement therapies in smoking cessation : a systematic review of effectiveness and economic analysis
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Wang, D., Connock, M., Barton, P., Fry-Smith, A., Aveyard, P. and Moore, D. (2008) 'Cut down to quit' with nicotine replacement therapies in smoking cessation : a systematic review of effectiveness and economic analysis. Health Technology Assessment, Vol.12 (No.2). iii-iv, ix. ISSN 1366-5278.
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Official URL: http://www.hta.ac.uk/execsumm/summ1202.htm
Abstract
Meta-analysis of RCT evidence of quit rates in NRT-supported smoking reduction studies indicates that NRT is an effective intervention in achieving sustained smoking abstinence for smokers who declare unwillingness or inability to attempt an abrupt quit. The 12-month sustained abstinence success rate in this population (approximately 5.3% with NRT versus approximately 2.6% with placebo) is considerably less than that documented for an abrupt quit NRT regime in smokers willing to attempt an abrupt quit with NRT (which according to other systematic reviews is around 16% with NRT versus 10% with placebo). Most of the evidence of effectiveness of CDTQ came from trials that required considerable patient-investigator contact. Therefore, for CDTQ with NRT to generate similar abstinence rates for this recalcitrant population in a real-world setting would probably require a similar mode of delivery. The modelling undertaken, which was based on reasonable assumptions about costs, benefits and success rates, suggests that CDTQ is highly cost-effective compared with no quit attempt. CDTQ remains cost-effective if dilution from abrupt quitting forms a small proportion of CDTQ attempts. In an alternative analysis in which smokers who switch from an abrupt quit to CDTQ retain the success rate of abrupt quitters, all forms of CDTQ appear cost-effective. Randomised trials in recalcitrant smokers allowing head-to-head comparison of CDTQ delivered with various modalities would be informative.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Health Technology Assessment | ||||
Publisher: | National Coordinating Centre for Health Technology Assessment | ||||
ISSN: | 1366-5278 | ||||
Official Date: | 2008 | ||||
Dates: |
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Volume: | Vol.12 | ||||
Number: | No.2 | ||||
Page Range: | iii-iv, ix | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published |
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