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The length of follow-up ranged from 4 weeks to 2 years. Each study took a different approach to measuring adherence (see below). Smoking outcome was assessed as continuous abstinence and validated by exhaled carbon monoxide (CO) in four of the five studies [22, 26, 27, 29]. The association between adherence and abstinence was assessed by means of a ALK logistic regression in four and by a ��2 test in one study [28]. Details of the 37 papers addressing the association between adherence and abstinence but not controlling for relapse as a cause for non-adherence are provided in Supporting information, Table S1. Information on included studies is summarized in Table?1. Due to the heterogeneity of the studies discussed above, this section provides short narrative summaries of the five included studies. Shiffman [22] conducted a secondary analysis of a randomized controlled trial of nicotine lozenges versus placebo in 1030 smokers. Participants were instructed to use lozenges for 6 weeks. Adherence to study medication was monitored daily during the first 2 weeks of the trial, using an interactive voice response system. In the absence of an a priori definition of adherence, study participants were categorized as ��high�� or ��low�� lozenge users based on a median split of the entire cohort. The mean number of lozenges used per day was 10.2?��?2.5 in the ��high�� users group and 5.1?��?1.9 in the ��low�� users group. Smoking outcome was defined as continuous selleckchem selleck 28-day abstinence, validated by exhaled CO at 6 weeks. In order to control for confounding by non-adherence due to relapse, the analysis (logistic regression) included participants only who had remained abstinent for the first 2 weeks of the trial (i.e. the period during which adherence was monitored daily). Thus, a dichotomized parameter of lozenge use during the first 2 weeks was examined as a predictor of continuous abstinence at 6 weeks in those who had been randomized to active treatment and who had not relapsed during the first 2 weeks (sample size not reported). The odds of continuous abstinence were significantly higher for ��high�� lozenge users in both the unadjusted model [odds ratio (OR)?=?1.60; 95% confidence interval (CI): 1.13�C2.27; P?
