Cytisine versus varenicline for smoking cessation in New Zealand indigenous Māori: a randomized controlled trial.
Aim: To determine whether cytisine was at least as effective as varenicline in supporting smoking abstinence for ≥ 6 months in New Zealand indigenous Māori or whānau (extended‐family) of Māori, given the high smoking prevalence in this population. Design Pragmatic, open‐label, randomized, community‐...
| Publicado en: | Addiction Vol. 116; no. 10; pp. 2847 - 2859 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=152291206&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 152291206 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Oct2021 vid: 116 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 152291206 150101028 152291206 152291206 10.1111/add.15489 152291206 ppf: 2847 ppct: 12 formats: fmt: @attributes: type: P tig: atl: Cytisine versus varenicline for smoking cessation in New Zealand indigenous Māori: a randomized controlled trial. aug: au: Walker, Natalie Smith, Barry Barnes, Joanne Verbiest, Marjolein Parag, Varsha Pokhrel, Subhash Wharakura, Mary‐Kaye Lees, Tina Cubillos Gutierrez, Huber Jones, Brian Bullen, Christopher affil: National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand sug: subj: Smoking Cessation Varenicline Therapeutic Use Alkaloids Therapeutic Use Maori Indigenous Peoples New Zealand Smoking Epidemiology Human Randomized Controlled Trials New Zealand Adult Support, Psychosocial Treatment Outcomes Intention Descriptive Statistics Confidence Intervals Odds Ratio Quality of Life Self Report Patient Compliance Sensitivity and Specificity Adult: 19-44 years ab: Aim: To determine whether cytisine was at least as effective as varenicline in supporting smoking abstinence for ≥ 6 months in New Zealand indigenous Māori or whānau (extended‐family) of Māori, given the high smoking prevalence in this population. Design Pragmatic, open‐label, randomized, community‐based non‐inferiority trial. Setting: Bay of Plenty, Tokoroa and Lakes District Health Board regions of New Zealand. Participants: Adult daily smokers who identified as Māori or whānau of Māori, were motivated to quit in the next 2 weeks, were aged ≥ 18 years and were eligible for subsidized varenicline. Recruitment used multi‐media advertising. Interventions: A total of 679 people were randomly assigned (1 : 1) to receive a prescription for 12 weeks of cytisine or varenicline, plus low‐intensity cessation behavioural support from the prescribing doctor and community stop‐smoking services or a research assistant. Day 5 of treatment was the designated quit date. Measurements The primary outcome was carbon monoxide‐verified continuous abstinence at 6 months, analysed as intention‐to‐treat (with multiple imputation for missing data). Secondary outcomes measured at 1, 3, 6 and 12 months post‐quit date included: self‐reported continuous abstinence, 7‐day point prevalence abstinence, cigarettes per day, time to (re)lapse, adverse events, treatment adherence/compliance and acceptability, nicotine withdrawal/urge to smoke and health‐care utilization/health‐related quality of life. Findings Verified continuous abstinence rates at 6 months post‐quit date were 12.1% (41 of 337) for cytisine versus 7.9% (27 of 342) for varenicline [risk difference 4.29%, 95% confidence interval (CI) = –0.22 to 8.79; relative risk 1.55; 95% CI = 0.97–2.46]. Sensitivity analyses confirmed that the findings were robust. Self‐reported adverse events over 6 months occurred significantly more frequently in the varenicline group (cytisine: 313 events in 111 participants; varenicline: 509 events in 138 participants, incidence rate ratio 0.56, 95% CI = 0.49–0.65, P < 0.001) compared with the cytisine group. Common adverse events were headache, nausea and difficulty sleeping. Conclusion: A randomized controlled trial found that cytisine was at least as effective as varenicline at supporting smoking abstinence in New Zealand indigenous Māori or whānau (extended‐family) of Māori, with significantly fewer adverse events. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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