Intervention Review

Anxiolytics for smoking cessation

  1. John R Hughes1,*,
  2. Lindsay F Stead2,
  3. Tim Lancaster3

Editorial Group: Cochrane Tobacco Addiction Group

Published Online: 20 JAN 2010

Assessed as up-to-date: 4 OCT 2009

DOI: 10.1002/14651858.CD002849

Database Title

Additional Information

How to Cite

Hughes JR, Stead LF, Lancaster T. Anxiolytics for smoking cessation. Cochrane Database of Systematic Reviews 2000, Issue 4. Art. No.: CD002849. DOI: 10.1002/14651858.CD002849.

Author Information

  1. 1

    University of Vermont, Dept of Psychiatry, Burlington, Vermont, USA

  2. 2

    University of Oxford, Department of Primary Care Health Sciences, Oxford, UK

  3. 3

    University of Oxford, Department of Primary Health Care, Oxford, UK

*John R Hughes, Dept of Psychiatry, University of Vermont, UHC Campus, OH3 Stop # 482, 1 South Prospect Street, Burlington, Vermont, 05401, USA. john.hughes@uvm.edu.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 20 JAN 2010

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

There are two reasons to believe anxiolytics might help in smoking cessation. Anxiety may be a symptom of nicotine withdrawal. Secondly, smoking could be due to an attempt to self-medicate an anxiety problem.

Objectives

The aim of this review is to assess the effectiveness of anxiolytic pharmacotherapy in aiding long term smoking cessation. The drugs include buspirone; diazepam; doxepin; meprobamate; ondansetron; and the beta-blockers metoprolol, oxprenolol and propanolol.

Search methods

We searched the Cochrane Tobacco Addiction Group specialised register (most recent search October 2009), which includes trials indexed in MEDLINE, EMBASE, SciSearch and PsycINFO, and conference abstracts.

Selection criteria

We considered randomized trials comparing anxiolytic drugs to placebo or an alternative therapeutic control for smoking cessation. We excluded trials with less than six months follow up.

Data collection and analysis

We extracted data in duplicate on the type of study population, the nature of the drug therapy, the outcome measures, method of randomization, and completeness of follow up.

The main outcome measure was abstinence from smoking after at least six months follow up in patients smoking at baseline. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. Where appropriate, we performed meta-analysis of relative risks using a fixed effect model.

Main results

There was one trial each of the anxiolytics diazepam, meprobamate, metoprolol and oxprenolol. There were two trials of the anxiolytic buspirone. None of the trials showed strong evidence of an effect for any of these drugs in helping smokers to quit. However, confidence intervals were wide, and an effect of anxiolytics cannot be ruled out on current evidence.

Authors' conclusions

There is no consistent evidence that anxiolytics aid smoking cessation, but the available evidence does not rule out a possible effect.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Do pharmacotherapies which reduce anxiety help smokers to quit

Anxiety can contribute to increased smoking, and may be a smoking withdrawal symptom. Medications to reduce anxiety (anxiolytics) may theoretically help smokers trying to quit. There have not been many trials, and none of them showed strong evidence of an effect on quitting.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

抗焦慮劑在戒菸的應用

兩大理由可以佐証抗焦慮劑可以應用在戒菸.焦慮可以是尼古丁戒斷的症狀之ㄧ.第二點在於抽菸可能是一種人們應對焦慮問題的自我治療方式.

目標

本篇文獻回顧的目標在於評估抗焦慮劑在幫助長期戒菸的效果.此類藥物包括buspirone; diazepam; doxepin; meprobamate; ondansetron.另外還有betablockers metoprolol, oxprenolol and propanolol.

搜尋策略

我們搜尋the Cochrane Tobacco Addiction Group specialised register (最新搜尋2009年10月),包括在MEDLINE, EMBASE, SciSearch and PsycINFO 等資料庫的試驗與相關摘要.

選擇標準

我們考慮抗焦慮劑和安慰劑或替代治療對照組對於戒菸的隨機分配試驗.且我們排除少於6個月追蹤期的試驗.

資料收集與分析

我們解讀實驗數值包括試驗族群的類型，藥物治療的性質，試驗的結果，隨機分佈的方法及追蹤的完整性。評估主要結果的方法在於追蹤患者停止吸菸至少6個月以上。我們對每個試驗使用最精細的戒菸定義及可利用，可信賴的生化評估，以適當的方式，我們使用固定效果模型來表現後設分析。

主要結論

其中一項試驗包含的抗焦慮劑diazepam, meprobamate, metoprolol and oxprenolol。另外兩項試驗的抗焦慮劑為buspirone。沒有一項試驗可以提供任一項抗焦慮劑對於幫助戒菸的足夠證據。然而，廣泛的信賴區間以及抗焦慮劑其中的一項效果在目前證據中都不能排除其效果。

作者結論

抗焦慮劑在幫助戒菸方面並未有一致性的證據，但可得的證據並未排除可能的效果。

翻譯人

本摘要由彰化基督教醫院張庭綱翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

降低焦慮的藥物並未展現幫忙戒菸的效果。焦慮可以增加抽菸且可以為抽菸戒斷的症狀之一，降低焦慮的藥物(抗焦慮劑)理論上可以幫助抽菸者嘗試戒菸，目前沒有很多相關試驗且並未呈現足夠對於戒煙的效果。

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