PT  - JOURNAL ARTICLE
AU  - R. Strassmann
AU  - B. Bausch
AU  - A. Spaar
AU  - J. Kleijnen
AU  - O. Braendli
AU  - M. A. Puhan
TI  - Smoking cessation interventions in COPD: a network meta-analysis of randomised trials
AID  - 10.1183/09031936.00167708
DP  - 2009 Sep 01
TA  - European Respiratory Journal
PG  - 634--640
VI  - 34
IP  - 3
4099  - http://erj.ersjournals.com/content/34/3/634.short
4100  - http://erj.ersjournals.com/content/34/3/634.full
SO  - Eur Respir J2009 Sep 01; 34
AB  - The aim of this study was to rank order the effectiveness of smoking cessation interventions for chronic obstructive pulmonary disease (COPD) patients. We searched 10 databases to identify randomised trials of smoking cessation counselling (SCC) with or without pharmacotherapy or nicotine replacement therapy (NRT). We conducted a network meta-analysis using logistic regression analyses to assess the comparative effectiveness of smoking cessation interventions while preserving randomisation of each trial. The analysis of 7,372 COPD patients from six out of eight identified trials showed that SCC in combination with NRT had the greatest effect on prolonged abstinence rates versus usual care (OR 5.08, p<0.0001) versus SCC alone (2.80, p = 0.001) and versus SCC combined with an antidepressant (1.53, p = 0.28). The second most effective intervention was SCC combined with an antidepressant (3.32, p = 0.002) versus SCC alone (1.83, p = 0.007), with no difference between antidepressants. SCC alone was of borderline superiority compared with usual care (1.81, p = 0.07). A small body of evidence suggests that SCC combined with NRT is more effective than other combinations and single smoking cessation treatments in COPD, but substantially more research is needed for this most important COPD treatment.