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Neuberger questions our conclusions on the Allen Carr Easyway. As he
points out, the observational data on abstinence rates are contradictory.
This illustrates the difficulty of judging the efficacy of interventions
without clinical trial data. Drug companies would not be permitted to
make the claims of effectiveness made by Allen Carr Easyway without having
funded independent clinical trials. Allen Carr Easyway should fund such
Neuberger also suggests that we ignore evidence of the harm from
nicotine replacement therapy (NRT) in pregnancy. We believe the
literature is insufficient to show whether NRT is completely safe and
there is still insufficient evidence of its efficacy in pregnancy to
confidently recommend it. However, based on clear evidence of its
efficacy in non-pregnant populations(1), and based on clinical reasoning
that a lower dose of nicotine from NRT(2) is safer than a higher dose with
additional toxins from cigarettes, there should be a presumption of use in
pregnancy. The UK drug regulatory authority also concluded this.
1. Silagy C, Lancaster T, Stead L, Mant D, Fowler G. Nicotine
replacement therapy for smoking cessation. Nicotine replacement therapy
for smoking cessation Cochrane Database of Systematic Reviews: Reviews
2004 Issue 3 John Wiley & Sons, Ltd Chichester, UK DOI: 10
1002/14651858 CD000146 pub2 2004;(3).
2. Benowitz NL. Pharmacology of Nicotine: Addiction and Therapeutics. Annu
Rev Pharmacol Toxicol 1996; 36(1):597-613.
These are the same as in our original article
No competing interests
20 July 2007
NIHR Career Scientist
Department of Primary Care, University of Birmingham, Birmingham B15 2TT, UK