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. 2020 Oct 14;2020(10):CD010216. doi: 10.1002/14651858.CD010216.pub4

Summary of findings 1. Nicotine EC compared to NRT for smoking cessation.

Nicotine EC compared to NRT for smoking cessation
Patient or population: People who smoke
Setting: New Zealand, UK, USA
Intervention: Nicotine EC
Comparison: NRT
Outcomes Anticipated absolute effects* (95% CI) Relative effect
(95% CI) № of participants
(studies) Certainty of the evidence
(GRADE) Comments
Risk with NRT Risk with Nicotine EC
Smoking cessation at 6 months to 1 year
Assessed with biochemical validation
Study population RR 1.69
(1.25 to 2.27) 1498
(3 RCTs) ⊕⊕⊕⊝
MODERATEa
6 per 100 10 per 100
(8 to 14)
Adverse events at 4 weeks to 6 months
Assessed by self‐report
Study population RR 0.98
(0.80 to 1.19) 485
(2 RCTs) ⊕⊕⊝⊝
LOWb
45 per 100 44 per 100
(36 to 53)
Serious adverse events at 4 weeks to 1 year
Assessed via self‐report and medical records
Study population RR 1.37
(0.77 to 2.41) 727
(2 RCTs) ⊕⊕⊝⊝
LOWb
5 per 100 7 per 100
(4 to 13)
*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). For cessation, the assumed risk in the control group is based on assumed quit rates for NRT assuming receipt of limited behavioural stop‐smoking support (as per Hartmann‐Boyce 2018a). The assumed risk for adverse events and serious adverse events is a weighted mean average of quit rates across control groups in contributing studies.

CI: Confidence interval; RCT: randomised controlled trial; RR: Risk ratio
GRADE Working Group grades of evidenceHigh 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

aDowngraded one level due to imprecision; small number of events (< 300 overall).
bDowngraded two levels due to imprecision; confidence intervals encompass clinically‐important harm as well as clinically important benefit.