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. 2020 Jul 15;202(2):e5–e31. doi: 10.1164/rccm.202005-1982ST

Table 4.

Evidentiary Basis for Conditional Recommendation Favoring Varenicline over Electronic Cigarettes, with Very-Low-Certainty Evidence

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.