Thanigaimani, Shiv, Drovandi, Aaron, and Golledge, Jonathan (2022) A meta-analysis of randomised controlled trials evaluating the efficacy of smoking cessation interventions in people with peripheral artery disease. Journal of Vascular Surgery, 75 (2). 721-729.e7.

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Abstract

Objective: This review aimed to systematically pool evidence from randomised clinical trials (RCT) on the efficacy of interventions in assisting smoking cessation in participants with PAD.

Methods: Publicly available databases were searched for RCTs testing the effect of interventional programs in achieving smoking cessation in participants with PAD who were current smokers. The primary outcome was smoking cessation at the end of follow-up. Meta-analyses were performed using random effect models and reported as risk ratios (RR) and 95% confidence intervals (CI). Risk of bias and publication bias were assessed using a modified version of the Cochrane Collaboration’s tool and funnel plots respectively.

Results: Six RCTs testing smoking cessation programs comprising physician advice, behavioural counselling from an expert delivered in-person or over the telephone and provision of nicotine replacement therapy and/or varenicline in 558 smokers with PAD were included. Meta-analysis suggested that overall these interventions did not significantly increase the chance of quitting smoking (RR: 1.48 [95% CI 0.84, 2.61]), with low heterogeneity between studies (I2=20%) which were robust in sensitivity analyses. Risk of bias was high, moderate, and low in one, three and two studies respectively. A funnel plot suggested a low risk of publication bias.

Conclusion: Overall previously tested smoking cessation interventions have not been effective in achieving smoking cessation in people with PAD. Further research is needed to develop and test interventions which can effectively help current smokers with PAD quit.

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