NRT - Failure rate of 98.4%

British Medical Journal Response
29 Apr 2009

Commenting on the British Medical Journal into the effectiveness of Nicotine Replacement Therapy (NRT).

It appears to me that the conclusions of this paper are highly slanted. With a long-term smoking cessation percentage of only 1.6%, one can hardly call NRT treatment an "effective" intervention in this situation. Even though the 1.6% abstinence rate is better than the 0.4% achieved with placebo, how can one call the 1.6% success rate with NRT to be "effective?"

In fact, the logical conclusion from this paper is that NRT was a dismal intervention. The overwhelming majority of smokers - 98.4% - failed to achieve long-term sustained abstinence with NRT treatment.

Given the presence of a financial conflict of interest with a pharmaceutical company that manufactures nicotine replacement products, it certainly has the appearance that this conflict has biased the interpretation of the findings and the study conclusion.

I can't quite think of another intervention for which a 98.4% failure rate would be considered a success.

Michael Siegel, Professor Boston University School of Public Health,

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