Summary of findings 5. Fast‐acting nicotine replacement therapy compared to nicotine patch for smoking cessation.
| Fast‐acting nicotine replacement therapy compared to nicotine patch for smoking cessation | ||||||
| Patient or population: people who smoke Setting: any; studies conducted in: Europe, USA Intervention: fast‐acting nicotine replacement therapy (NRT) Comparison: nicotine patch | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with nicotine patch | Risk with fast‐acting NRT | |||||
| Smoking cessation | Study population | RR 0.90 (0.77 to 1.05) | 3319 (8 RCTs) | ⊕⊕⊕⊕ Higha | ‐ | |
| 164 per 1000 | 148 per 1000 (126 to 172) | |||||
| Overall serious adverse events | Study population | ‐ | 1252 (4 RCTs) | ⊕⊝⊝⊝ Very lowb,c | Three of the four studies had no events in either arm. In the one study in which serious adverse events were reported (n = 642), the confidence interval was wide (RR 1.75, 95% CI 0.52 to 5.92). | |
| See comment | See comment | |||||
| Treatment withdrawals | Study population | RR 4.23 (1.54 to 11.63) | 1482 (3 RCTs) | ⊕⊝⊝⊝ Very lowb,d | ‐ | |
| 5 per 1000 | 23 per 1000 (8 to 63) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; NRT: nicotine replacement therapy; RCT: randomised controlled trial; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aWe rated most studies at low or unclear risk of bias. However, we did not downgrade the certainty of the evidence, as limiting the analysis only to studies we judged to be at low risk of bias resulted in a consistent effect estimate and 95% confidence interval. bDowngraded by two levels due to imprecision: fewer than 100 events overall. cDowngraded by one level due to risk of bias: two of the four studies were at high risk of bias. dDowngraded by one level due to risk of bias: two of the three studies were at high risk of bias.