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Cochrane Database of Systematic Reviews Review - Intervention

Clonidine for smoking cessation

Authors' declarations of interest

Version published: 19 July 2004 Version history

https://doi.org/10.1002/14651858.CD000058.pub2
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Background

Clonidine was originally used to lower blood pressure. It acts on the central nervous system and may reduce withdrawal symptoms in various addictive behaviours, including tobacco use.

Objectives

The aim of this review is to determine clonidine's effectiveness in helping smokers to quit.

Search methods

We searched the Cochrane Tobacco Addiction Group trials register for trials of clonidine. Date of the most recent search: June 2008.

Selection criteria

We considered randomized trials of clonidine versus placebo with a smoking cessation endpoint assessed at least 12 weeks following the end of treatment.

Data collection and analysis

We extracted data in duplicate on the type of subjects, the dose and duration of clonidine therapy, the outcome measures, method of randomization, and completeness of follow up.

The main outcome measure was abstinence from smoking after at least 12 weeks follow up in patients smoking at baseline. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. Where appropriate, we performed meta‐analysis using a fixed effect model.

Main results

Six trials met the inclusion criteria. There were three trials of oral, and three of transdermal clonidine. Some form of behavioural counselling was offered to all participants in five of the six trials.

There was a statistically significant effect of clonidine in one of these trials. The pooled risk ratio for success with clonidine versus placebo was 1.63 (95% confidence interval 1.22 to 2.18). There was a high incidence of dose‐dependent side‐effects, particularly dry mouth and sedation.

Authors' conclusions

Based on a small number of trials, in which there are potential sources of bias, clonidine is effective in promoting smoking cessation. Prominent side‐effects limit the usefulness of clonidine for smoking cessation.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Does clonidine help smokers to quit

Clonidine is a drug used to lower blood pressure, but it may also reduce drug and alcohol withdrawal symptoms. The review of trials found that clonidine can lead to a small increase in the number of people likely to quit smoking. However, the quality of the trials was poor, which makes the evidence less reliable. Adverse effects of clonidine included a dry mouth and sedation. Clonidine may not be the best option for people trying to quit smoking, but it might be useful for people who are not helped by nicotine replacement therapy or antidepressants.

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