Wednesday, July 17, 2013

Pfizer's "Don't Go Cold Turkey" Campaign Highlights Widespread Misunderstanding of the Scientific Evidence on Quitting

Pfizer - the maker of Chantix - is running a "Don't Go Cold Turkey" campaign which "aims to ensure smokers who want to quit are aware of the help available to them from their healthcare professional and understand how taking the right approach can significantly increase the chances of successfully breaking the cycle of nicotine dependence."

According to the press release: "Dr Sarah Jarvis, medical broadcaster and practising GP, says: “As a GP, my main aim is to get people to look at leading healthier lifestyles and one of the most important lifestyle change is stopping smoking. I’m aware that the vast majority of people who do smoke are either desperate to quit or have tried and failed in the past. I want those who are motivated to quit to consider that there is support available and that by speaking with their healthcare professional or local stop smoking service, they can increase their chances of success by up to four times, compared to going “cold turkey”."

The Rest of the Story

One of the greatest misconceptions in tobacco control is that the use of medication improves the chances of quitting compared to "cold turkey" quitting. This is also one of the greatest examples of the miscommunication of scientific data in tobacco control, and Pfizer demonstrates it perfectly here.

The scientific evidence shows clearly that spontaneous (unplanned) cold turkey quitting is more effective than planned, medication-assisted quitting. The evidence also shows that on a population basis, the overwhelmingly most successful method used to quit is cold turkey quitting.

So why do so many anti-smoking practitioners and drug companies make these misleading statements that medication increases the odds of quitting compared to a cold turkey approach?

The answer is a misinterpretation (or misrepresentation) of the scientific evidence. There are many clinical trials demonstrating that medications such as Chantix are more effective than placebo. But that doesn't mean it is more effective than cold turkey quitting. It merely means that when you take a group of people who want to try to quit using medication and then you give them a medication that turns out to be a sham, it doesn't work.

To make the statement that medication is more effective than cold turkey quitting, one would have to compare a group of smokers given medication to a similar group who are motivated to quit cold turkey. You cannot randomize people to quit cold turkey because it takes a sincere desire to do so and a high level of motivation.

Such a study has never been done; however, retrospective studies that compare true cold turkey quitting with medication-assisted quitting uniformly show that the cold turkey approach is more effective.

It is easy to understand why Pfizer would misrepresent the science. But why is there such a high prevalence of misrepresentation of the data among anti-smoking groups and practitioners?

At least part of the answer, I believe, is the tremendous amount of funding that anti-smoking researchers and groups have received from Big Pharma. When you have a research organization such as the Society for Research on Nicotine and Tobacco which takes huge amounts of money from Big Pharma, it should come as no surprise that there is so much misrepresentation of the scientific evidence in the anti-smoking movement.

(Thanks to Shadow Guest for the tip.)

No comments: