Letters

Community based heart health promotion project in England

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7132.704a (Published 28 February 1998) Cite this as: BMJ 1998;316:704

Self reporting overestimates smoking cessation rates

  1. John Muir, Senior research fellow,
  2. Tim Lancaster, Senior research fellow,
  3. Godfrey Fowler, Professor,
  4. Andrew Neil, Lecturer
  1. General Practice Research Group, Radcliffe Infirmary, Oxford OX2 6HE
  2. Department of Epidemiology and Public Health Medicine, University of Bristol, Bristol BS8 2PR
  3. University Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London NW3 2PF
  4. Barnsley Health Authority, Barnsley S75 2PY
  5. Wiltshire Health Authority, Devizes SN10 5EQ
  6. School of Health and Related Research, Sheffield S1 4DA
  7. Rotherham Priority Health Services NHS Trust, Doncaster Gate Hospital, Rotherham S65 1DW

    EDITOR—Baxter et al state that their community intervention led to a 6.9% difference in smoking rates.1 Quitting was defined by self report in questionnaires. In previous studies, reported smoking cessation has been reduced when self reporting has been checked against biochemical markers. For example, in the OXCHECK study 30% of those who reported having stopped smoking were classified as smokers by cotinine estimations.2 Self reported dietary change was similarly greater than actual change in serum lipid concentrations.

    The effects of this intervention are likely to be considerably less than the authors claim. The authors are not justified in concluding that their intervention is superior to other forms of health promotion that have been subjected to more rigorous evaluation.2

    References

    1. 1.
    2. 2.

    Authors' conclusions are unjustified and misleading

    1. George Davey Smith, Professor of clinical epidemiology,
    2. Shah Ebrahim, Professor of clinical epidemiology
    1. General Practice Research Group, Radcliffe Infirmary, Oxford OX2 6HE
    2. Department of Epidemiology and Public Health Medicine, University of Bristol, Bristol BS8 2PR
    3. University Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, London NW3 2PF
    4. Barnsley Health Authority, Barnsley S75 2PY
    5. Wiltshire Health Authority, Devizes SN10 5EQ
    6. School of Health and Related Research, Sheffield S1 4DA
    7. Rotherham Priority Health Services NHS Trust, Doncaster Gate Hospital, Rotherham S65 1DW

      EDITOR—Baxter et al conclude that Rotherham's heart health promotion project was so successful that “the estimated cost per life year gained was £31.”1 If this were true it would be a stunning finding and the rapid redirection of a considerable bulk of health service resources should follow. Unfortunately, the evidence for their claim is thin.

      The evaluation was based on a before-after comparison in two intervention communities and one control community. These communities were not well matched, …

      View Full Text

      Sign in

      Log in through your institution

      Free trial

      Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
      Sign up for a free trial

      Subscribe