{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T22:00:48Z","timestamp":1783029648605,"version":"3.54.6"},"reference-count":52,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Pharmacotherapies for smoking cessation are widely prescribed, despite substantial concerns being raised regarding the potential increased risk of cardiovascular (CV) and neuropsychiatric adverse events associated with these treatments. This study aimed to assess the relative CV and neuropsychiatric safety between varenicline and bupropion compared with nicotine replacement therapies (NRT) in adults without a recent history of depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective new\u2010user cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>US administrative data from 2006 to 2016 covering more than 100 million individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Three study cohorts of new users, aged 18\u00a0years or older, limited to patients with no diagnosis or treatment for depression in the prior 12\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Propensity score adjusted log\u2010binomial regression models. The primary outcome was a composite of hospitalized CV events. Secondary outcomes included a composite of hospitalized neuropsychiatric events and individual components of the primary outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>A total of 618\u2009497 participants were included in our study cohorts. Compared with NRT (<jats:italic>n<\/jats:italic>\u00a0=\u00a032\u2009237), varenicline (<jats:italic>n<\/jats:italic>\u00a0=\u00a0454\u2009698) was associated with a 20% lower 1\u2010year CV risk [adjusted relative risk (RR)\u00a0=\u00a00.80, 95% confidence interval (CI)\u00a0=\u00a00.75\u20130.85], and bupropion (<jats:italic>n<\/jats:italic>\u00a0=\u00a0131\u2009562) was associated with a 25% lower 1\u2010year CV risk (RR\u00a0=\u00a00.75, 95% CI\u00a0=\u00a00.69\u20130.81). Varenicline was associated with a 35% lower 1\u2010year risk of neuropsychiatric hospitalization versus NRT (RR\u00a0=\u00a00.65, 95% CI\u00a0=\u00a00.59\u20130.72), and bupropion was associated with a 21% increase in 1\u2010year risk of neuropsychiatric hospitalization (RR\u00a0=\u00a01.21, 95% CI\u00a0=\u00a01.09\u20131.35).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Varenicline compared with nicotine replacement therapy does not appear to be associated with an increased risk of cardiovascular or neuropsychiatric hospitalizations. Bupropion appears to be associated with a lower risk of cardiovascular hospitalization and a higher risk of neuropsychiatric hospitalization, compared with nicotine replacement therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14951","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T05:01:06Z","timestamp":1582174866000},"page":"1534-1546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Cardiovascular and neuropsychiatric safety of smoking cessation pharmacotherapies in non\u2010depressed adults: a retrospective cohort study"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7438-5172","authenticated-orcid":false,"given":"Greg","family":"Carney","sequence":"first","affiliation":[{"name":"Therapeutics Initiative University of British Columbia  Vancouver BC Canada"},{"name":"Department of Anesthesiology, Pharmacology and Therapeutics University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Bassett","sequence":"additional","affiliation":[{"name":"Therapeutics Initiative University of British Columbia  Vancouver BC Canada"},{"name":"Department of Anesthesiology, Pharmacology and Therapeutics University of British Columbia  Vancouver BC Canada"},{"name":"Department of Family Practice University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Maclure","sequence":"additional","affiliation":[{"name":"Therapeutics Initiative University of British Columbia  Vancouver BC Canada"},{"name":"Department of Anesthesiology, Pharmacology and Therapeutics University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Taylor","sequence":"additional","affiliation":[{"name":"Lions Gate Hospital, Fraser Health Authority  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin R.","family":"Dormuth","sequence":"additional","affiliation":[{"name":"Therapeutics Initiative University of British Columbia  Vancouver BC Canada"},{"name":"Department of Anesthesiology, Pharmacology and Therapeutics University of British Columbia  Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"US Department of Health and Human Services.How Tobacco Smoke Causes Disease: What It Means to You. 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