Question

How effective are nicotine receptor partial agonists in helping people to stop smoking?

Bottom Line

Varenicline increases the odds of quitting smoking approximately three-fold compared with placebo (NNT 5-12 for abstinence at 52 weeks). The number of people stopping smoking with varenicline is significantly higher than with bupropion (NNT 9-24), and with a lower risk of serious adverse effects. Cytisine may also increase the chances of quitting, but the evidence at present is inconclusive.

Caveat

The main adverse effect of varenicline is nausea, mostly at mild to moderate levels. Nausea usually subsides over time and has little effect on discontinuation rates.

Context

Smoking is the most preventable cause of premature death, accounting for 17 per cent of all deaths in some developing countries.