{
  "abstract": "Objective To evaluate the comparative effectiveness and safety of pharmacological and non-pharmacological smoking cessation interventions in people with severe mental illnessDesign Systematic review and network meta-analysis.Data sources Medline, Embase, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science, from inception to 19 September 2024.Eligibility criteria for selecting studies Trials enrolling adults who had established diagnoses of schizophrenia, bipolar disorder, recurrent or current severe major depressive disorder, or post-traumatic stress disorder, randomised to a smoking cessation intervention versus another active treatment, placebo, standard care, or no treatment.Results 74 randomised controlled trials (11 023 participants) evaluating nine smoking cessation interventions were included in the study. Compared with placebo or minimal care, varenicline (10 more per 100 achieving long term smoking abstinence, 95% confidence interval (CI) 5 to 16; high certainty evidence) and bupropion (5 more per 100, 1 to 10; moderate certainty evidence) increased long term abstinence. Effects on short term smoking abstinence were similar. Nicotine replacement therapy improved short term abstinence but with little or no long term abstinence benefit (moderate certainty evidence). Combination interventions (pharmacological with non-pharmacological interventions) may increase long term abstinence (6 more per 100, 95% CI 3 to 11; low certainty evidence). The certainty of evidence for other interventions was very low. Serious adverse event data were highly uncertain. Dropout from a trial because of harms was possibly no different for varenicline, bupropion, and nicotine replacement therapy compared with placebo or minimal care.Conclusions Varenicline, bupropion, and nicotine replacement therapy likely improved smoking abstinence in people with severe mental illness compared with placebo or minimal care (moderate to high certainty evidence). Combined pharmacological and non-pharmacological approaches may offer more benefit (low certainty evidence), but the risk of serious adverse events for all interventions was very uncertain.Systematic review registration PROSPERO CRD42022349498.",
  "authors": [
    {
      "affiliations": [
        "Department of Public Health Care and Primary Care, Academic Centre of General Practice, KU Leuven, Leuven, Belgium",
        "Cebam-Belgian Centre for Evidence-Based Medicine, Leuven, Belgium",
        "Cochrane Belgium, Leuven, Belgium"
      ],
      "name": "Geertruida E Bekkering"
    },
    {
      "affiliations": [
        "University Psychiatric Centre KU Leuven, Leuven, Belgium"
      ],
      "name": "Johan Detraux"
    },
    {
      "affiliations": [
        "Basic Psychology and Methodology, Espinardo Compus, Faculty of Psychology, University of Murcia, Murcia, Spain",
        "Biomedical Research Institute of Murcia Pascual Parrilla-IMIB, Murcia, Spain"
      ],
      "name": "José A López-López"
    },
    {
      "affiliations": [
        "University Psychiatric Centre KU Leuven, Leuven, Belgium",
        "Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Leuven, Belgium",
        "KU Leuven, Leuven Brain Institute, Leuven, Belgium",
        "Antwerp Health Law and Ethics, University of Antwerp, Antwerp, Belgium"
      ],
      "name": "Marc De Hert"
    },
    {
      "affiliations": [
        "Massachusetts General Hospital, Department of Psychiatry, Boston, Massachusetts, USA",
        "Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "A Eden Evins"
    },
    {
      "affiliations": [
        "Cebam-Belgian Centre for Evidence-Based Medicine, Leuven, Belgium",
        "Cochrane Belgium, Leuven, Belgium"
      ],
      "name": "Anne-Catherine Vanhove"
    },
    {
      "affiliations": [
        "Community Health Centre De Bruggen, Brugge, Belgium"
      ],
      "name": "Hanne Cloetens"
    },
    {
      "affiliations": [
        "Family Medicine Department, Aseer Central Hospital, Abha, Saudi Arabia"
      ],
      "name": "Abdullah M Algarni"
    },
    {
      "affiliations": [
        "2Bergen, KU Leuven Libraries, Leuven, Belgium"
      ],
      "name": "Thomas Vandendriessche"
    },
    {
      "affiliations": [
        "Department of Medicine, University of Alberta, Edmonton, Alberta, Canada",
        "MAGIC Evidence Ecosystem Foundation, Oslo, Norway"
      ],
      "name": "Arnav Agarwal"
    },
    {
      "affiliations": [
        "MAGIC Evidence Ecosystem Foundation, Oslo, Norway",
        "Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada",
        "Division of General Internal Medicine and Division of Epidemiology, University Hospitals of Geneva, Geneva, Switzerland"
      ],
      "name": "Thomas Agoritsas"
    },
    {
      "affiliations": [
        "Department of Public Health Care and Primary Care, Academic Centre of General Practice, KU Leuven, Leuven, Belgium"
      ],
      "name": "Bert Aertgeerts"
    },
    {
      "affiliations": [
        "Department of Public Health Care and Primary Care, Academic Centre of General Practice, KU Leuven, Leuven, Belgium",
        "Public Health and Primary Care, KU Leuven-Kulak Kortrijk Campus, Kortrijk, Belgium"
      ],
      "name": "Nicolas Delvaux"
    },
    {
      "affiliations": [
        "Panoramaweg 47, Leuven, Brussels, Belgium"
      ],
      "name": "Mieke Vermandere"
    }
  ],
  "title": "Smoking cessation for people with severe mental illness: systematic review and network meta-analysis",
  "uid": "812ae1d3-7482-5289-b0fd-c532693c61f1"
}