Observational studyAddiction (Abingdon, England)2019
Does the nicotine metabolite ratio moderate smoking cessation treatment outcomes in real-world settings? A prospective study.
Observational study in Addiction (Abingdon, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 18 citations in OpenAlex.
- The Nicotine Metabolite Ratio and Response to Smoking Cessation Treatment Among People Living with HIV Who Smoke in South Africa.International journal of environmental research and public health · 2025Trial
- Naltrexone and alcohol effects on craving for cigarettes in heavy drinking smokers.Experimental and clinical psychopharmacology · 2019Trial
- Nicotine metabolite ratio and attitude towards nicotine metabolite ratio informed smoking cessation care in Jordan.Tobacco prevention & cessation · 2026Article
- Brain Cytochrome P450: Navigating Neurological Health and Metabolic Regulation.Journal of xenobiotics · 2025Review
- Can Treatment Support Mitigate Nicotine Metabolism-Based Disparities in Smoking Abstinence? Secondary Analysis of the Helping HAND 4 Trial.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Article
- The use of biomarkers to guide precision treatment for tobacco use.Addiction neuroscience · 2023Article
- Evaluation of the nicotine metabolite ratio in smoking patients treated with varenicline and bupropion.Frontiers in pharmacology · 2022Article
- Pharmacogenetics factors influencing smoking cessation success; the importance of nicotine metabolism.Expert opinion on drug metabolism & toxicology · 2021Review
- Associations Between Nicotine Metabolite Ratio and Gender With Transitions in Cigarette Smoking Status and E-Cigarette Use: Findings Across Waves 1 and 2 of the Population Assessment of Tobacco and Health (PATH) Study.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2020Article
- The Use of the Nicotine Metabolite Ratio as a Biomarker to Personalize Smoking Cessation Treatment: Current Evidence and Future Directions.Cancer prevention research (Philadelphia, Pa.) · 2020Review
- Does the nicotine metabolite ratio moderate smoking cessation treatment outcomes in real-world settings? A prospective study.Addiction (Abingdon, England) · 2019Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsIn smoking treatment trials comparing varenicline with transdermal nicotine replacement therapy (NRT), stratified by nicotine metabolite (3-hydroxycotinine/cotinine) ratio (NMR), the relative benefit of varenicline is greater among normal rather than slow metabolizers. This study tested if the relative effectiveness of varenicline and NRT is associated with NMR status in a natural treatment setting. A secondary aim was to test if this relationship is moderated by behavioural support.
designProspective observational multi-centre study with 4-week and 52-week follow-up.
settingNine English Stop Smoking Services (SSS).
participantsData came from 1556 smokers (aged ≥ 16 years) attending SSS between March 2012 and March 2013.
interventionsParticipants received pharmacotherapy together with behavioural support. MEASUREMENTS: The primary outcome was carbon monoxide-verified continuous abstinence at both follow-up times. Main explanatory variables were (1) NMR status [slow (NMR < 0.31, n = 451) versus normal (NMR ≥ 0.31, n = 1105) metabolizers]; (2) pharmacotherapy (varenicline versus NRT) and (3) behavioural support (individual versus group-based treatment). Analyses adjusted for baseline socio-demographic, SSS, mental/physical health and smoking characteristics.
findingsOf participants, 44.2% [95% confidence interval (CI) = 41.7-46.6%] and 8.0% (95% CI = 6.8-9.5%) were continuously abstinent at 4 and 52 weeks. Varenicline was more effective than NRT at 4 weeks (P < 0.001) but only marginally so at 52 weeks (P = 0.061). There was no or inclusive evidence that NMR status moderated relative efficacy of varenicline and NRT at 4- [P = 0.60, Bayes factor (BF) = 0.25] or 52-week follow-ups (P = 0.74, BF = 0.73). However, this relationship was moderated by behavioural support (p = 0.012): the relative benefit of varenicline over NRT at 52-week follow-up was greater in slow, not normal, metabolizers receiving group rather than individual support (P = 0.012).
conclusionsIn a real-world setting, the nicotine metabolite ratio status of treatment-seeking smokers does not appear to contribute substantially to the differential effectiveness of varenicline and nicotine replacement therapy in Stop Smoking Services, when both pharmacotherapy and behavioural support are self-selected.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.