Table 4.
Certainty Assessment |
Number (or Percent) |
Effect (95% CI) |
Certainty | Importance | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
No. of Studies | Study Design | Risk of Bias | Inconsistency | Indirectness | Imprecision | Other Considerations | Varenicline | Electronic Cigarette | Relative | Absolute (per 1,000 Patients) | ||
Point-prevalence tobacco abstinence, 6 mo or later (follow-up: mean, 24 wk) | ||||||||||||
1 | RCT | Serious | Not serious | Serious | Very serious | None | 13/27 (48.1%) | 32.5% | RR, 1.44 (0.75–2.80) | 143 more (↓81–↑585) | Very low | Critical |
Continuous abstinence, 6 mo or longer (follow-up: mean, 1 yr; assessed with persistent abstinence from all tobacco) | ||||||||||||
1 | Observational study | Serious | Not serious | Not serious | Serious | None | 156 | 200 | — | MD, 0.046 higher (↓0.018–↑0.11) | Very low | Critical |
Point-prevalence tobacco abstinence during treatment, not measured | ||||||||||||
— | — | — | — | — | — | — | — | — | — | — | — | Important |
Quality of life, not reported | ||||||||||||
— | — | — | — | — | — | — | — | — | — | — | — | Important |
Serious adverse events (follow-up: 24 wk) | ||||||||||||
1 | RCT | Serious | Not serious | Serious | Very serious | None | 0/27 (0.0%) | 0.0% | No estimate | — | Very low | Critical |
Relapse (follow-up: 1 yr) | ||||||||||||
1 | Observational study | Serious | Not serious | Not serious | Serious | None | 156 | 200 | — | MD, 0.065 higher (0–0) | Very low | Important |
Other substance use, not reported | ||||||||||||
— | — | — | — | — | — | — | — | — | — | — | — | Important |
Withdrawal, not reported | ||||||||||||
— | — | — | — | — | — | — | — | — | — | — | — | Important |
Definition of abbreviations: ↑ = increase of; ↓ = decrease of; CI = confidence interval; MD = mean difference; RCT = randomized controlled trial; RR = relative risk.
Indirect comparisons were used to estimate the relative effect. Varenicline treatment showed an uncertain benefit compared with electronic cigarettes but had significantly fewer adverse events than electronic cigarettes. For complete evidence tables, together with references, explanations of certainty assessments, and results of the Evidence-to-Decision process, see online supplement.