Efficacy of Pharmacotherapy for Smoking Cessation in Adolescent Smokers: A Meta-analysis of Randomized Controlled Trials
A partir d'une revue de la littérature publiée jusqu'en janvier 2018 (9 essais incluant au total 1 188 fumeurs âgés de 12 à 20 ans), cette méta-analyse évalue l'efficacité de la pharmacothérapie pour aider les adolescents à arrêter de fumer
Introduction : This study aimed to evaluate the efficacy of pharmacotherapy for smoking cessation among adolescent smokers by using a meta-analysis of randomized controlled trials (RCTs).
Methods : PubMed, EMBASE, and Cochrane Library were searched from the inception to January 20, 2018. We included RCTs of pharmacotherapy for smoking cessation among adolescent smokers aged less than 20 years. Data were pooled using a random-effects meta-analysis. The primary outcome measures were a smoking abstinence rate and its relative risk (RR) at the longest follow-up period in each study validated by biochemical markers.
Results : Among a total of 1035 articles searched, 9 RCTs, which involved 1188 adolescent smokers aged 12 to 20 years with 627 in the intervention group and 561 in the control group, were included in the final analysis. In the random-effects meta-analysis of all the 9 trials, pharmacotherapy showed a increased abstinence rate (relative risk [RR], 1.62; 95% confidence interval [CI], 1.08 to 2.44, I2 = 0.0%), compared to the control group. Subgroup meta-analyses by follow-up period showed an increased abstinence rate at 4 weeks (RR, 1.87; 95% CI, 1.22 to 2.87; n = 4) and a non-significantly increased abstinence rate during the longer-term follow-up periods at 8, 12, 24, and 52 weeks.
Conclusions : The current meta-analysis suggests that pharmacotherapy can be considered as an aid for smoking cessation in the short-term period among adolescent smokers. However, further large RCTs are warranted to determine its long-term efficacy and safety.
Implications : In this meta-analysis of 9 randomized controlled trials (RCTs) with 1188 adolescent smokers aged 12 to 20 years, pharmacotherapy showed an increased abstinence rate, compared to the control group. In the subgroup meta-analyses by follow-up period, it showed the increased abstinence rate at 4 weeks and no efficacy on abstinence during the longer-term follow-up periods up to 52 weeks. Further large RCTs are warranted to determine the long-term efficacy and safety of pharmacotherapy in adolescent smokers.
Nicotine & Tobacco Research , résumé, 2017