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Meta-Analysis
. 2012 Sep 12;2012(9):CD000191.
doi: 10.1002/14651858.CD000191.pub2.

Silver acetate for smoking cessation

Tim Lancaster  1 , Lindsay F Stead
Affiliations
Meta-Analysis

Silver acetate for smoking cessation

Tim Lancaster et al. Cochrane Database Syst Rev. .

Abstract

Background: Silver acetate produces an unpleasant taste when combined with cigarettes, thereby producing an aversive stimulus. It has been marketed in various forms with the aim of extinguishing the urge to smoke, by pairing the urge with an unpleasant stimulus.

Objectives: The aim of this review was to determine the effectiveness of silver acetate products (gum, lozenge, spray) in promoting smoking cessation.

Search methods: We searched the Cochrane Tobacco Addiction Group specialised trials register. Most recent search was in July 2012.

Selection criteria: We included randomised trials of silver acetate for smoking cessation with reports of smoking status at least six months after the beginning of treatment.

Data collection and analysis: We extracted data in duplicate on the type of subjects, the dose and form of silver acetate, the outcome measures, method of randomisation, and completeness of follow-up.The main outcome measure was biochemically validated abstinence from smoking after at least six months follow-up in patients smoking at baseline. Subjects lost to follow-up were counted as continuing smokers. Where appropriate, we performed meta-analysis using a fixed effects model.

Main results: Two studies provided long-term follow-up data on patients randomised to silver acetate or placebo. In one of these studies, there was a third arm, randomised to 2mg nicotine gum. The pooled risk ratio for quitting for silver acetate vs placebo was 1.04 (95% confidence interval 0.69 to 1.57).

Authors' conclusions: Existing trials show little evidence for a specific effect of silver acetate in promoting smoking cessation. The confidence intervals for the ratio are quite wide. However, the upper limit of the confidence intervals for a positive effect equates to an absolute increase in the smoking cessation rate of about 4%. Any effect of this agent is therefore likely to be smaller than nicotine replacement therapy. The lack of effect of silver acetate may reflect poor compliance with a treatment whose rationale is to create an unpleasant stimulus.

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Conflict of interest statement

None

Figures

1.1
1.1. Analysis
Comparison 1 Silver acetate vs placebo, Outcome 1 Sustained abstinence at 12 months.
2.1
2.1. Analysis
Comparison 2 Silver acetate vs nicotine gum, Outcome 1 Sustained abstinence at 12 months.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Hymowitz 1996 {published data only}
    1. Hymowitz N, Eckholdt H. Effects of a 2.5‐mg silver acetate lozenge on initial and long‐term smoking cessation. Preventive Medicine 1996;25:537‐46. - PubMed
Jensen 1990 {published data only}
    1. Jensen EJ, Schmidt E, Pedersen B, Dahl R. Effect of nicotine, silver acetate, and ordinary chewing gum in combination with group counselling on smoking cessation. Thorax 1990;45:831‐4. - PMC - PubMed
    1. Jensen EJ, Schmidt E, Pedersen B, Dahl R. Effect on smoking cessation of silver acetate, nicotine and ordinary chewing gum. Influence of smoking history. Psychopharmacology Berl 1991;104:470‐4. - PubMed
    1. Jensen EJ, Schmidt E, Pedersen B, Dahl R. The effect of nicotine, silver acetate, and placebo chewing gum on the cessation of smoking. The influence of smoking type and nicotine dependence. International Journal of the Addictions 1991;26:1223‐31. - PubMed
Malcolm 1986 {published data only}
    1. Malcolm RE, Currey HS, Mitchell MA, Keil JE. Silver acetate gum as a deterrent to smoking. Chest 1986;90:107‐11. - PubMed

References to studies excluded from this review

Hymowitz 1993 {published data only}
    1. Hymowitz N, Feuerman M, Hollander M, Frances RJ. Smoking deterrence using silver acetate. Hospital and Community Psychiatry 1993;44:113‐114, 118. - PubMed
Morrow 1993 {published data only}
    1. Morrow R, Nepps P, McIntosh M. Silver acetate mouth spray as an aid in smoking cessation: results of a double‐blind trial. Journal of the American Board of Family Practice 1993;6(4):353‐7. - PubMed
Rose 2010 {published data only}
    1. Rose JE, Behm FM, Murugesan T, McClernon FJ. Silver acetate interactions with nicotine and non‐nicotine smoke components. Experimental and Clinical Psychopharmacology 2010;18:462‐9. - PubMed
Rosenberg 1977 {published data only}
    1. Rosenberg A. An investigation into the effect on cigarette smoking of a new anti‐smoking chewing gum. Journal of International Medical Research 1977;5:68‐70. - PubMed
Zmeili 1999 {published data only}
    1. Zmeili S, Salhab A, Shubair K, Gharaibeh M, Suliman N, Al‐Kayed A, et al. Clinical evaluation of a new AS mouth wash 881010 as an antismoking agent: a placebo‐controlled double‐blind trial. International Journal of Clinical Pharmacology and Therapeutics 1999;37:41‐50. - PubMed

Additional references

Cahill 2012
    1. Cahill K, Stead LF, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database of Systematic Reviews 2012, Issue 4. [DOI: 10.1002/14651858.CD006103.pub6] - DOI - PubMed
Deeks 2011
    1. Deeks JJ, Higgins JPT, Altman DG (editors). Chapter 9: Analysing data and undertaking meta‐analyses. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. Available from www.cochrane‐handbook.org.. The Cochrane Collaboration, 2011.
Stead 2008
    1. Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database of Systematic Reviews 2008, Issue 1. [DOI: 10.1002/14651858.CD000146.pub3] - DOI - PubMed

References to other published versions of this review

Lancaster 1997
    1. Lancaster T, Stead LF. Silver acetate for smoking cessation. Cochrane Database of Systematic Reviews 1997, Issue 3. [DOI: 10.1002/14651858.CD000191] - DOI - PubMed

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