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Systematic review of Swedish snus for smoking cessation based on primary subject data from randomised clinical trials

Published online by Cambridge University Press:  10 April 2013

L. E. Rutqvist ,
J. S. Fry  and
P. N. Lee
L. E. Rutqvist*
Affiliation:
Scientific Affairs Group, Swedish Match AB, Stockholm, Sweden
J. S. Fry
Affiliation:
P. N. Lee Statistics and Computing Ltd, Sutton, Surrey, UK
P. N. Lee
Affiliation:
P. N. Lee Statistics and Computing Ltd, Sutton, Surrey, UK
*
Address for correspondence: Lars Erik Rutqvist, MD, PhD, Swedish Match AB, Maria Skolgata 83, SE-118 85, Stockholm, Sweden. Email: lars-erik.rutqvist@swedishmatch.com
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Abstract

Introduction: The ability of Swedish snus to serve as a smoking cessation aid has been documented in several observational, population surveys from Scandinavia, but randomised clinical trials provide more reliable information on efficacy. Aims: To perform a systematic review and meta-analysis of randomised clinical trials of Swedish snus as an aid to smoking cessation. Methods: Literature searches were conducted in MedLine, Cochrane Library, and Embase to identify relevant clinical trials. The primary outcome was defined as biologically confirmed smoking cessation during around six months. Meta-analyses based on primary subject data tested for effect of allocated treatment as well as selected baseline characteristics. Results: There were two relevant clinical trials, one conducted at five sites in the US (n = 250), the other at two sites in Serbia (n = 319). Based on the primary outcome, success was higher in the treated group in both Serbia (5.7% vs 1.9%) and the US (4.0% vs 1.6%). Meta-analysis estimated the relative success rate at 2.83 (95% CI 1.03–7.75), which was of borderline significance (exact p = 0.06, chi-squared p = 0.03). For smoking cessation in the last 4 weeks of each study, rates were 12.4% for snus and 6.6% for placebo (RR 1.86, 95% CI 1.09-3.18). Efficacy of snus was not clearly related to any baseline characteristic. Conclusions: Swedish snus increased quit rates similarly in US and Serbia. These results confirm and extend previous information based on observational population surveys.

Keywords

Systematic reviewrandomised trialsmoking cessationSwedish snus
Type
Articles
Information
Journal of Smoking Cessation , Volume 8 , Issue 1 , June 2013 , pp. 33 - 44
Copyright
Copyright © The Authors 2013 

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