Introduction
Smoking is one of the main risk factors for many chronic diseases, and
it is still the main preventable cause of disease and premature death in
the world. It is of great significance to implement smoking cessation
treatment for all smokers. Nicotine
contained in tobacco products can trigger the release of dopamine and
other neurotransmitters in the brain, thereby enhancing smokers’
dependence on tobacco. 1 However, smoking is an
addictive behavior, for most smokers, it is difficult for them to quit
smoking
permanently.
In a survey of more than 5000 adults in England in 2006, about half of
smokers have tried to quit smoking at least once in the past year, and
it is estimated that there is a permanent smoking cessation rate of 2%
to 3% every year. 2
For smokers with alcohol problems, they face greater health risks and it
is more difficult to quit smoking. Globally, the disability adjusted
life years of tobacco and alcohol use rank fourth and fourth and fifth
respectively. 3 The co-occurrence of smoking and
drinking is a significant public health concern, tobacco use and alcohol
use disorder have a high prevalence of comorbidities. Smoking combined
with alcohol use has negative health effects, including but not limited
to increased cancer risk and mortality. 4-6Epidemiological studies show that there is a strong positive correlation
between smoking and drinking. 3,7 For example, a study
published in 2006 investigated cigarette smoking and the risk for
alcohol use disorders among adolescent drinkers, and the results showed
that smokers had 4.5-fold higher odds of alcohol use disorders than
never-smokers. 8 Compared with people who do not drink
alcohol, alcoholics have a higher smoking rate. 9-11For example, Elissa R. et al. conducted a survey in US colleges, and the
most obvious finding is that 44-59% of alcoholic drinkers smoke.12 And clinical trials have shown that drinking after
quitting smoking will promote the recurrence of smoking.13 It can be seen that it may be more difficult for
smokers who use alcohol to quit smoking. Therefore, smoking cessation
treatment for alcoholics can not only improve the success rate of
smoking cessation, but also reduce the cost of medical care.
Drug therapy is the most common way to quit smoking. Randomized
controlled trials (RCTs) are widely acknowledged as the design of choice
for evaluating the effectiveness of health care. 14,15Many clinical trials and systematic reviews have revealed the
effectiveness of some drugs in smoking cessation. In order to verify the
effectiveness of different drugs on alcoholic smokers, a network
meta-analysis is conducted in this study. At present, there are some
clinical trials on smoking cessation of alcoholic smokers with different
drug treatments. The existing traditional systematic review can only
compare the effects of experimental drugs and control treatment. The
purpose of this network meta-analysis is to directly or indirectly
compare the smoking cessation effects of a variety of different drugs on
alcoholic smokers, so as to rank the smoking cessation effects of
different drugs.