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Tseng PT, Jeng JS, Zeng BS, Stubbs B, Carvalho AF, Brunoni AR, Su KP, Tu YK, Wu YC, Chen TY, Lin PY, Liang CS, Hsu CW, Chen YW, Li CT. Efficacy of non-invasive brain stimulation interventions in reducing smoking frequency in patients with nicotine dependence: a systematic review and network meta-analysis of randomized controlled trials. Addiction 2022; 117:1830-1842. [PMID: 34347916 DOI: 10.1111/add.15624] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 06/09/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Nicotine is a highly addictive substance in tobacco products that dysregulates several neurotransmitters in the brain and impairs executive function. Non-invasive brain stimulation (NIBS) methods such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are promising treatments for nicotine dependence. We investigated the efficacy and acceptability of NIBS in managing smoking cessation through a systematic review and network meta-analysis (NMA). METHODS We conducted a systematic review to identify randomized controlled trials (RCTs) that investigated the efficacy of NIBS for smoking cessation. All pairwise meta-analyses and NMA procedures were conducted using random-effects and frequentist models. The co-primary outcomes were (1) the change in number of cigarettes smoked per day (change in frequency of smoking) in patients with nicotine dependence after NIBS and (2) acceptability (the dropout rate). The effect sizes for co-primary outcomes of change in frequency of smoking and acceptability were assessed according to standardized mean difference (SMD) and odds ratio, respectively. RESULTS Twelve RCTs with 710 participants (mean age: 44.2 years, 31.2% female) were included. Compared with the sham control, 10-Hz rTMS over the left dorsolateral prefrontal cortex (DLPFC) was associated with the largest changes in smoking frequency [SMD = -1.22, 95% confidence interval (95% CI) = -1.77 to -0.66]. The 2-mA bifrontal tDCS (SMD = -0.97, 95% CI = -1.32 to -0.62) and 10-Hz deep rTMS over the bilateral DLPFC with cue provocation (SMD = -0.77, 95% CI = -1.20 to -0.34) were associated with a significantly larger decrease in smoking frequency versus the sham. None of the investigated NIBSs was associated with dropout rates significantly different from those of the sham control groups. CONCLUSION Prefrontal non-invasive brain stimulation interventions appear to reduce the number of cigarettes smoked with good acceptability.
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Affiliation(s)
- Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung, Taiwan.,Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan.,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Jia-Shyun Jeng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bing-Syuan Zeng
- Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Positive Ageing Research Institute (PARI), Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK
| | - Andre F Carvalho
- IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - Andre R Brunoni
- Service of Interdisciplinary, Neuromodulation, Department and Institute of Psychiatry, Laboratory of Neurosciences (LIM-27), University of Sao Paulo, Sao Paulo, Brazil.,Interdisciplinary Center for Applied Neuromodulation University Hospital, University of Sao Paulo, Sao Paulo, Brazil
| | - Kuan-Pin Su
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Psychiatry and Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology and Neurology, Kaohsiung, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan.,Institute of Cognitive Neuroscience, National Central University, Jhongli, Taiwan.,Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Liu D, Zhu L, Yang C. The effect of preoperative smoking and smoke cessation on wound healing and infection in post-surgery subjects: A meta-analysis. Int Wound J 2022; 19:2101-2106. [PMID: 35451193 DOI: 10.1111/iwj.13815] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 11/27/2022] Open
Abstract
A meta-analysis was performed to evaluate the preoperative smoking and smoke cessation on wound healing and infection in post-surgery subjects. A systematic literature search up to January 2022 incorporated 11 trials involving 218 567 subjects after post-surgery at the beginning of the study; 176 670 were smoke cessation or non-smokers, and 41 897 were smokers. Statistical tools like the dichotomous method were used within a random or fixed-influence model to establish the odds ratio (OR) with 95% confidence intervals (CIs) to evaluate the influence of preoperative smoking and smoke cessation on wound healing and infection in post-surgery subjects. Smoke cessation or non-smokers had significantly lower postoperative wound healing problems (OR, 0.59; 95% confidence interval, 0.43-0.82, P < .001), and surgical site wound infection (OR, 0.74; 95% CI, 0.63-0.87, P < .001) compared with smokers in post-surgery subjects. Smoke cessation or non-smokers had significantly lower postoperative wound healing problems, and surgical site wound infection compared with smokers in post-surgery subjects. Furthermore, evidence is needed to confirm the outcomes.
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Affiliation(s)
- Dazhen Liu
- Department of Urology, General Hospital, Tianjin Medical University, Tianjin, China
| | - Long Zhu
- Department of Urology, General Hospital, Tianjin Medical University, Tianjin, China
| | - Changhai Yang
- Department of Urology, General Hospital, Tianjin Medical University, Tianjin, China
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Chang CP, Huang WH, You CH, Hwang LC, Lu IJ, Chan HL. Factors Correlated with Smoking Cessation Success in Older Adults: A Retrospective Cohort Study in Taiwan. Int J Environ Res Public Health 2019; 16:E3462. [PMID: 31540355 DOI: 10.3390/ijerph16183462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 01/02/2023]
Abstract
Smoking cessation in the elderly is very important. This study aims to explore the success rate of smoking cessation in the elderly and the factors that predict the success of smoking cessation. We collected data from smokers ≥60 years who visited a medical center in Taiwan during 2017. All patients were prescribed either varenicline or nicotine replacement therapy (NRT) for smoking cessation. The participants were asked about their smoking status after treatment. In total, 129 participants were enrolled. The three- or six-month point abstinence rate was 48.1%. No significant difference was found among baseline characteristics (including age, gender, underlying diseases, smoking duration, daily consumption amount of cigarette, carbon monoxide concentration, Fagerström test for nicotine dependence scores, and treatment method) between quitters and non-quitters, except for the type of medication used. The proportion of quitters using varenicline was significantly higher than that of non-quitters. Multivariate regression analyses showed that the patients who received varenicline were 3.22 times more likely to quit smoking than those who received NRT. Therefore, we suggest that varenicline use may help in smoking cessation in older adults, compared to NRT. Other baseline characteristics may not affect the success rate of smoking cessation in this population.
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Hsieh MT, Tseng PT, Wu YC, Tu YK, Wu HC, Hsu CW, Lei WT, Stubbs B, Carvalho AF, Liang CS, Yeh TC, Chen TY, Chu CS, Li JC, Yu CL, Chen YW, Li DJ. Effects of different pharmacologic smoking cessation treatments on body weight changes and success rates in patients with nicotine dependence: A network meta-analysis. Obes Rev 2019; 20:895-905. [PMID: 30816006 DOI: 10.1111/obr.12835] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 01/30/2023]
Abstract
Smoking cessation is a public health priority to reduce smoking-related morbidity and mortality. However, weight gain is a known primary reason for not trying to quit smoking. The aim of the current study was to investigate differences in weight gain associated with different pharmacological smoking cessation interventions. Randomized controlled trials (RCTs) that reported weight gain related to pharmacologic treatments for smoking cessation were analysed using network meta-analysis with a random effects model. Thirty-one RCTs with 5650 participants were included. Ten drugs and 22 regimens were identified. Nicotine patches plus fluoxetine, topiramate with/without nicotine patches, nicotine patches plus methylphenidate, nicotine spray/gum/lozenges, high-dose nicotine patches (42 mg/21 mg), naltrexone with/without nicotine patches, or bupropion with/without nicotine patches were associated with less weight gain than the placebo/control arm. Nicotine patches plus fluoxetine were associated with the least weight gain of all smoking cessation treatments. In addition, the nicotine patch plus topiramate and nicotine inhaler was associated with the best success rate and the least dropout rate, respectively. Overall, the nicotine patch 14 mg plus fluoxetine 40 mg, nicotine patch 14 mg plus fluoxetine 20 mg, and topiramate 200 mg would be the three best pharmacologic treatments based upon both weight gain effect and success rate.
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Affiliation(s)
- Meng-Tsang Hsieh
- Department of Neurology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ping-Tao Tseng
- WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan
| | - Yi-Cheng Wu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Hung-Chi Wu
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Te Lei
- Division of Allergy, Immunology, Rheumatology Disease, Department of Pediatrics, Mackay Memorial Hospital, Hsinchu, Taiwan
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, UK.,Positive Ageing Research Institute (PARI), Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Andre F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Addiction & Mental Health (CAMH), Toronto, Canada
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Ta-Chuan Yeh
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Che-Sheng Chu
- Department of Psychiatry and Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Juo-Chi Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Ling Yu
- Department of Pharmacy, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
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