Authors respond to criticism that treatment is ineffective

doi:10.1136/bmj.b1979

Published 20 May 2009, doi:10.1136/bmj.b1979
Cite this as: BMJ 2009;338:b1979

Letters

Nicotine replacement therapy

Authors respond to criticism that treatment is ineffective

The first 150 words of the full text of this article appear below.

Siegel is surprised that we concluded that nicotine replacementtherapy was effective and cannot think of other interventionsthat would be regarded as effective with such a high failurerate.¹ He chooses a secondary outcome from our review to makehis point, but as it excludes 76% of all the people who stoppedsmoking for a long time, this is not an accurate measure ofthe impact of the programme. Overall, offering up to one yearof treatment with nicotine replacement therapy helped 6.75%–3.28%=3.47%,or 1 in 29 users sustain long term abstinence. About half willbecome lifetime abstainers, about half of whom will be preventedfrom premature death,² which gives a number needed to treat(NNT) for prevention of premature death of about 120.

This NNT compares favourably with other preventive interventions.Five years of treatment with statins in those at risk of cardiovasculardisease gives an NNT of . . . [Full text of this article]

Paul Aveyard, senior lecturer¹, David Moore, senior reviewer¹, Martin Connock, systematic reviewer¹, Dechao Wang, systematic reviewer¹, Anne Fry-Smith, information specialist¹, Pelham Barton, senior lecturer¹

¹ School of Health and Population Sciences, University of Birmingham, Birmingham B15 2TT

p.n.aveyard@bham.ac.uk

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