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Key strengths include the exceptionally large sample size, long follow-up, and detailed adjustment for clinical, behavioral, and socioeconomic confounders, allowing robust assessment of interactions between initiation age and smoking intensity

This study, a systematic review and meta-analysis of 39 randomized clinical trials with 10,761 participants, found no evidence of an increased risk of suicide or attempted suicide, suicidal ideation, depression or death with varenicline. The authors did acknowledge that the drug could cause insomnia and abnormal dreams, side effects that were already well recognized

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