Nicotine Replacement Therapy OTC
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Results
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Comment
An important message is that nicotine replacement therapy (NRT) obtained
over-the-counter (OTC) from pharmacies works as well as that obtained by
prescription [1]. An extensive search strategy looked for randomised studies
comparing OTC NRT with placebo, and OTC NRT with prescription NRT.
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Results
Four randomised trials studied 2,290 subjects over 2.5 to six months with slightly
different definitions of quit rates. Pooled quit rates were 9.6% with OTC NRT and
4.0% with placebo (Figure 1). The pooled relative benefit was 2.4 (1.7 to 3.3), and
the number needed to treat for one person to quit smoking was 18 (13 to 29).
Figure 1: OTC NRT versus placebo (open circles), or OTC NRT versus prescription
NRT (filled circles)
Of four controlled studies of OTC NRT versus prescription NRT with 9,307
subjects over six to 12 months only two were randomised. Pooled quit rates were
8.9% with OTC NRT and 8.1% with prescription NRT (Figure 1). The pooled relative
benefit was 1.1 (0.9 to 1.3), showing no difference.
Comment
There are a number of methodological issues in this meta-analysis. It makes
useful reading, though, especially in relation to arguments about whether OTC NRT
is less effective than prescription NRT, and about the absolute efficacy of NRT.
There seems to be no difference, and that with NRT about 10 smokers in 100 will
stop smoking with NRT, about twice as many as without it.
References:
- JR Hughes et al. A meta-analysis of the efficacy of over-the-counter
nicotine replacement. Tobacco Control 2003 12: 21-27.
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