Tuesday, January 21, 2014

New Surgeon General's Report Hides Studies on Unaided Smoking Cessation and Hides Conflicts of Interest of Report Authors

Despite its massive 978-page length, the new Surgeon General's report - released last Friday - fails to include any mention of the many population-based studies which have shown that unaided smoking cessation is superior to the use of nicotine replacement therapy (NRT).

This glaring omission in the report was first revealed in a detailed and insightful commentary by John Polito, at whyquit.com.

Polito writes: "Physicians and government health workers are asked to ignore the fact that, as found by a July 2013 Gallup Poll, more patients quit smoking cold turkey than by all other methods combined, that only a tiny fraction of successful cessation involves use of any approved product (just 8 percent). Reflect on the fact that after 30 years and billions spent marketing Nicorette, that the Gallup Poll found that only 1 in 100 succeeded via nicotine gum. ... Fifty years of progress? Survey after survey teaches that feeding nicotine to nicotine addicts has nailed cessation to the floor, and that force-feeding weaning programs are costing lives (see Doran 2006, Hartman 2006, West 2006, Cheong 2007, Ferguson 2009, Pierce 2012). Don't expect to find any abrupt nicotine cessation paper cited in the General's 978 page report. None. Why? Because the 50th Anniversary Surgeon General report invited a number of financially conflicted researchers to help write it. Although impossible to know the role each played, to these eyes, their master's bidding leaps from the report."

Polito includes a table which compares the cessation success rates of unaided quitting compared to drugs in population-based studies. For heavy smokers, NRT achieves a 9% success rate compared to 15% for unassisted quitting.

This information is not included in the massive report.

The Rest of the Story

The inferiority of drugs to abrupt cold turkey quitting is not the only thing that the massive Surgeon General's report is hiding.

The report is also hiding the fact that many of its authors have or had financial conflicts of interest with pharmaceutical companies that manufacture the products about which the report provides a misleadingly positive review.

In fact, the report fails to disclose any of the many conflicts of interest of its authors with Big Pharma.

This lack of transparency in the report is unfortunate because readers deserve to be informed about financial conflicts of interest that could potentially have influenced the report's presentation and interpretation of the scientific evidence. This is especially important because the report makes broad conclusions regarding national strategies for smoking cessation. Thus, if the report's authors have received money from pharmaceutical companies that make the very products about which the report is opining, it would be critical to disclose these conflicts. The report fails to do so.

This not only supports Polito's hypothesis that the report's blatant bias in reporting on smoking cessation is due to the financial conflicts of its authors, who were doing their "master's bidding," but it also suggests that the producers of this report truly have something to hide.

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