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No evidence of the efficacy of nicotine for Alzheimer's disease

Nicotine has been related to recovery of memory in humans and animal models and some observational studies have been compatible with a protective effect of nicotine inhalation against Alzheimer's disease. At present, there is great controversy over this possible effect of tobacco use, and evidence is inconclusive. This review found no evidence on which to recommend nicotine for Alzheimer's disease.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Nicotine for schizophrenia

People with schizophrenia tend to smoke heavily and to a greater extent when compared to other patient groups. In this review we aimed to investigate this by searching for good quality evidence from randomised controlled trials on the effect of nicotine for schizophrenia, and/or to ascertain whether nicotine modifies the side effects of antipsychotics. Unfortunately we found no trials that met our inclusion criteria to support or refute this. There is a need for good quality randomised controlled trials that investigate the effects of nicotine for schizophrenia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Transdermal nicotine for the treatment of active ulcerative colitis

Ulcerative colitis is largely a disease of nonsmokers and patients who have quit smoking. Randomised controlled trials were therefore developed to test the hypothesis that nicotine patches can induce remission of a flare of ulcerative colitis. This review provides evidence that transdermal nicotine is superior to placebo (fake patch) for the treatment of active ulcerative colitis. However, patients treated with transdermal nicotine were significantly more likely to experience side effects than patients receiving placebo or standard medical therapy. Its use is therefore limited in some patients. The review did not identify any significant advantage for transdermal nicotine therapy compared to standard medical therapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Nicotine for postoperative pain

This Cochrane review examines whether nicotine given prior to, during, or immediately after surgery results in less pain, use of opioids, and side effects from opioids.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Can nicotine vaccines help people stop smoking or help stop recent quitters from relapsing?

Nicotine is the main addictive component in tobacco. When a person smokes a cigarette, nicotine causes chemicals in the brain to be released, which gives a feeling of reward to the smoker. This reward is part of the reason why people keep smoking. Nicotine vaccines are designed to work by reducing the effects of nicotine on the brain, meaning the smoker will feel less of a reward when they smoke a cigarette. By reducing the pleasure felt when smoking, vaccines may help smokers to stop smoking or help stop recent quitters from starting to smoke again.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Can nicotine replacement therapy (NRT) help people quit smoking?

NRT aims to reduce withdrawal symptoms associated with stopping smoking by replacing the nicotine from cigarettes. NRT is available as skin patches that deliver nicotine slowly, and chewing gum, nasal and oral sprays, inhalers, and lozenges/tablets, all of which deliver nicotine to the brain more quickly than from skin patches, but less rapidly than from smoking cigarettes. This review includes 150 trials of NRT, with over 50,000 people in the main analysis. We found evidence that all forms of NRT made it more likely that a person's attempt to quit smoking would succeed. The chances of stopping smoking were increased by 50 to 70%. The evidence suggests no overall difference in effectiveness between different forms of NRT, nor a benefit for using patches beyond eight weeks. NRT works with or without additional counselling, and does not need to be prescribed by a doctor. Heavier smokers may need higher doses of NRT. People who use NRT during a quit attempt are likely to further increase their chance of success by using a combination of the nicotine patch and a faster acting form or by combining the patch with the antidepressant bupropion. Data suggest that starting to use NRT patches shortly before the planned quit date may increase the chance of success. Adverse effects from using NRT are related to the type of product, and include skin irritation from patches and irritation to the inside of the mouth from gum and tablets. There is no evidence that NRT increases the risk of heart attacks.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Can nicotine receptor partial agonists, including cytisine and varenicline, help people to stop smoking?

When people stop smoking they experience cravings to smoke and unpleasant mood changes. Nicotine receptor partial agonists aim to reduce these withdrawal symptoms and the pleasure people usually experience when they smoke. The most widely‐available treatment in this drug type is varenicline, which is available world‐wide as an aid for quitting smoking. Cytisine is a similar medication, but is only available in Central and Eastern European countries and through internet sales.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Does use of nicotine replacement therapy while continuing to smoke undermine cessation? A systematic review

Bibliographic details: Beard E, Aveyard P, Michie S, McNeill A, West R.  Does use of nicotine replacement therapy while continuing to smoke undermine cessation? A systematic review. Journal of Smoking Cessation 2013; 8(1): 45-56

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Nicotine Replacement Therapy for Smoking Cessation or Reduction: A Review of the Clinical Evidence [Internet]

Cigarette smoking is associated with cancer, respiratory disease, and cardiovascular disease. It is reported that 19% of Canadians aged 15 years and older were smokers in 2007. Each year, approximately 45,000 Canadians die from smoking. Cigarette smoking is considered the leading preventable cause of mortality. Smoking cessation reduces the risk of developing and dying from smoking-related diseases. Although approximately 70 percent of smokers plan to quit and over 40 percent of smokers report that they tried to quit, the long-term success rate of any unaided quit attempt is low, with only 3 to 7 percent of smokers who make an attempt still abstinent one year later. With optimal treatment, one-year cessation rates after a single quit attempt can exceed 30 percent.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: January 16, 2014
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Nicotine Replacement Therapy, Bupropion and Varenicline for Tobacco Cessation: A Review of Clinical Effectiveness [Internet]

This review aims to address questions of clinical effectiveness for nicotine replacement therapy (NRT), bupropion, and varenicline in the general population of tobacco users. The findings of this report should be considered in the context of the previous CADTH Health Technology Assessment (HTA) on the subject, which employed a more thorough methodology and analysis of the primary studies on this topic.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: March 8, 2016
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'Cut down to quit' with nicotine replacement therapies in smoking cessation: a systematic review of effectiveness and economic analysis

Approximately 25% of adults in the UK are smokers. Smoking is associated with numerous diseases, including cancer and heart disease, and smokers have reduced life expectancy. Nicotine in cigarettes renders them addictive so that smokers generally find it extremely difficult to give up their habit. Most smokers (around 70%) say they would like to stop but some express an unwillingness or inability to do so in the near future. Nicotine replacement therapy (NRT) attempts to substitute the nicotine obtained from smoking with that derived from gum, inhaler or patch, so that smokers are enabled to quit smoking and then gradually become independent of nicotine.

NIHR Health Technology Assessment programme: Executive Summaries - NIHR Journals Library.

Version: 2008

Effectiveness of over-the-counter nicotine replacement therapy: a qualitative review of nonrandomized trials

AIM: Randomized trials conducted in over-the-counter (OTC) settings have shown that nicotine replacement therapy (NRT) is effective. This paper reviews nonrandomized tests of the effectiveness of OTC NRT.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Does mecamylamine help people to stop smoking

Mecamylamine is a drug originally marketed for lowering blood pressure, which was found to block the rewarding effects of nicotine. At doses high enough to do this, though, mecamylamine can have significant adverse effects, including drowsiness, hypotension and constipation. It has been suggested that smaller doses may work well with nicotine replacement therapy (NRT), and the two therapies may offset each other's adverse effects. Our review of trials found that while mecamylamine did not have a great effect on quitting rates, it may enhance the effectiveness of NRT and is worth further research.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Electronic nicotine delivery systems ("e-cigarettes"): review of safety and smoking cessation efficacy

BACKGROUND AND OBJECTIVES: Cigarette smoking is common among cancer patients and is associated with negative outcomes. Electronic nicotine delivery systems ("e-cigarettes") are rapidly growing in popularity and use, but there is limited information on their safety or effectiveness in helping individuals quit smoking.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Do any interventions help smokers who have successfully quit for a short time to avoid relapsing?

Some people start smoking again shortly after quitting and are said to have 'relapsed'. Interventions used to help people avoid relapse usually focus on teaching the skills to cope with temptations to smoke. This approach and others have not been shown to be helpful, either for people who quit on their own or with the help of treatment, or for those who quit because they were pregnant or in hospital. Many trials conducted so far have not been of a strong enough design to detect possible small effects. Among drug treatments, extended use of varenicline may help some smokers. Studies of extended use of nicotine replacement treatment are urgently needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Are there any effective interventions to help individuals with schizophrenia to quit or to reduce smoking?

People with schizophrenia are very often heavy smokers. It is uncertain whether treatments that have been shown to help other groups of people to quit smoking are also effective for people with schizophrenia. In this review, we analysed studies which investigated a wide variety of interventions. Our results suggested that bupropion (an antidepressant medication previously shown to be effective for smoking cessation) helps patients with schizophrenia to quit smoking. The effect was clear at the end of the treatment and it may also be maintained after six months. Patients who used bupropion in the trials did not experience any major adverse effect and their mental state was stable during the treatment. Another medication, varenicline (a nicotine partial agonist which has been shown to be an effective intervention for smoking cessation in smokers without schizophrenia), also helps individuals with schizophrenia to quit smoking at the end of the treatment. However, this evidence is only based on two studies. We did not have sufficient direct evidence to know whether the benefit of varenicline is maintained for six months or more. In addition, there has been ongoing concern of potential psychiatric adverse events including suicidal ideas and behaviour among smokers who use varenicline. We found that two patients, among 144 who used varenicline, had either suicidal ideas or behaviour. Smokers with schizophrenia who receive money as a reward for quitting may have a higher rate of stopping smoking whilst they get payments. However, there is no evidence that they will remain abstinent after the reward stops. There was too little evidence to show whether other treatments like nicotine replacement therapy and psychosocial interventions are helpful.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Ways to help people stop using smokeless tobacco (including chewing tobacco, snuff and snus)

Smokeless tobacco is any product in which tobacco is held in the mouth so that nicotine is absorbed through the lining of the mouth. Smokeless tobacco is less dangerous than cigarettes and other products where tobacco is burnt and nicotine absorbed through the lungs. However, smokeless tobacco still leads to nicotine addiction and can be harmful, especially to the mouth. Many types of smokeless tobacco are used around the world, including chewing tobacco, snuff and snus. The risks to health vary with the type of product.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Using pharmacological medications for unilateral spatial neglect (USN) after stroke

USN (difficulty recognizing the left or right side of the body and space) has been associated with poor independence and long stays in hospitals and rehabilitation centers, all of which predispose people with stroke to the risk of falls and to semi permanent or permanent wheelchair use, which can reduce their quality of life. Furthermore, this condition decreases the ability of people to return to work. Pharmacological medication for USN, such as dopamine and noradrenergic agonists or pro‐cholinergic treatment, could have a positive effect in improving independence for people after stroke. This review aims to answer this question.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

What is the best way to help people with chronic obstructive pulmonary disease stop smoking?

We wanted to find out the best way to help people with chronic obstructive pulmonary disease (COPD) to stop smoking.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Systematic review and meta-analysis of the efficacy and tolerability of nicotine preparations in active ulcerative colitis

BACKGROUND: Findings from clinical studies of the efficacy and tolerability of nicotine preparations in maintaining remission of ulcerative colitis (UC) have been inconsistent.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

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