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Role of Herbal Medication in Tobacco Cessation Treatment: A Systematic Review and Meta-analysis.

  • 2023-01-29
  • Addiction & health 15(1)
    • Ruchi Mitra
    • Arpita Rai
    • Ansul Kumar
    • Jeewan Kumar Mitra

Study Design

Type
Review
Sample size
n = 12
Population
12 trials with 762 smokers
Methods
Systematic review and meta-analysis of randomized controlled trials; search of seven databases from December 2020 to April 2021; data extracted independently by two teams

Background

Literature reports randomized trials have examined herbal drugs and other smoking cessation therapies such as aromatherapy acupuncture but no comprehensive overview of the overall results has been provided. The present systematic review and meta-analysis aimed to describe the overall effectiveness and safety of herbal medicines.

Methods

This study was conducted from December 2020 to April 2021 by searching seven databases. Herbal drugs have been shown to help people quit smoking in randomized controlled studies. Two teams of researchers independently extracted the data.

Findings

A total of 12 trials with 762 smokers were included in this study. The heterogeneity I2 was 43.6% with P=0.03 (Cochrane Q test) and χ2=15.77. The overall odds ratio (OR) at 95% confidence interval (CI) was 0.91 (0.68- 1.20) which shows a protective factor of herbal preparations and very low heterogeneity. The herbal treatments such as Vernonia cinerea, St. John's Wort, and lavender essential oil were significantly related to a higher continuous abstinence rate (CAR) compared to the controls with risk ratio (RR): 2.13 (0.57-4.61) at week 8; RR: 2.72 (0.77-5.3) at week 12; and RR: 2.77 (0.37-1.13) at week 24. A 7-day point abstinence rate (PAR) at week 8 was RR: 1.24 (0.81-6.34) with 95% CI; RR: 2.09 (0.93-8.29) at week 12, and RR: 2.11 (0.3-3.08) at week 24. Black pepper and lime were better in craving reduction than the placebo group. This study found no significant difference between the treatment and control groups in adverse effects, despite some minor side effects with herbal drugs.

Conclusion

The results of this study showed herbal treatments have the potential to help smokers quit the habit. Further well-designed trials comparing standardized herbal medicines with conventional therapy and placebo are recommended to reinforce this data.

Research Insights

  • Black Pepper→Reduced Craving

    Black pepper and lime were better in craving reduction than the placebo group.

    Effect
    Beneficial
    Effect size
    Small
  • Lavender→Increased 7-Day Point Abstinence Rate

    A 7-day point abstinence rate (PAR) at week 8 was RR: 1.24 (0.81-6.34) with 95% CI; RR: 2.09 (0.93-8.29) at week 12, and RR: 2.11 (0.3-3.08) at week 24.

    Effect
    Neutral
    Effect size
    Small
  • Lavender→Increased Continuous Abstinence Rate

    herbal treatments such as Vernonia cinerea, St. John's Wort, and lavender essential oil were significantly related to a higher continuous abstinence rate (CAR) compared to the controls with risk ratio (RR): 2.13 (0.57-4.61) at week 8; RR: 2.72 (0.77-5.3) at week 12; and RR: 2.77 (0.37-1.13) at week 24.

    Effect
    Beneficial
    Effect size
    Large
  • Lime→Reduced Craving

    Black pepper and lime were better in craving reduction than the placebo group.

    Effect
    Beneficial
    Effect size
    Small
  • St. John's Wort→Increased 7-Day Point Abstinence Rate

    A 7-day point abstinence rate (PAR) at week 8 was RR: 1.24 (0.81-6.34) with 95% CI; RR: 2.09 (0.93-8.29) at week 12, and RR: 2.11 (0.3-3.08) at week 24.

    Effect
    Neutral
    Effect size
    Small
  • St. John's Wort→Increased Continuous Abstinence Rate

    herbal treatments such as Vernonia cinerea, St. John's Wort, and lavender essential oil were significantly related to a higher continuous abstinence rate (CAR) compared to the controls with risk ratio (RR): 2.13 (0.57-4.61) at week 8; RR: 2.72 (0.77-5.3) at week 12; and RR: 2.77 (0.37-1.13) at week 24.

    Effect
    Beneficial
    Effect size
    Large
  • ironweed→Increased 7-Day Point Abstinence Rate

    A 7-day point abstinence rate (PAR) at week 8 was RR: 1.24 (0.81-6.34) with 95% CI; RR: 2.09 (0.93-8.29) at week 12, and RR: 2.11 (0.3-3.08) at week 24.

    Effect
    Neutral
    Effect size
    Small
  • ironweed→Increased Continuous Abstinence Rate

    herbal treatments such as Vernonia cinerea, St. John's Wort, and lavender essential oil were significantly related to a higher continuous abstinence rate (CAR) compared to the controls with risk ratio (RR): 2.13 (0.57-4.61) at week 8; RR: 2.72 (0.77-5.3) at week 12; and RR: 2.77 (0.37-1.13) at week 24.

    Effect
    Beneficial
    Effect size
    Large
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