More Than Two Thirds Ex-Smokers Quit Cold Turkey
It has become the norm physicians to offer smokers nicotine-replacement therapy when advising them on how to quit smoking. Researchers at the School of Public Health in Sydney, Australia have found that two-thirds to three-quarters of smokers quit unaided – cold turkey.
Simon Chapman and Ross MacKenzie have published their findings in the latest issue of of PLoS Medicine, including their criticism of what they call the "medicalization of smoking cessation" which they do not believe to be backed by evidence.
The researchers performed a Medline search for “smoking cessation” in May 2009, limiting results to English language original articles, meta-analyses, and reviews published in 2007 and 2008. They found 511 studies dealing with cessation interventions.
Of the intervention papers, 467 (91.4%) reported the effects of assisted cessation and 44 (8.6%) described the impact of unassisted cessation. Of the 467 studies on interventions, 247 (52.9%) involved pharmacotherapy and 220 (47.1%) non-drug interventions.
The authors state, “With approximately two-thirds to three-quarters of ex-smokers stopping unaided, our finding that 91.3% of recent intervention studies focused on assisted cessation.”
“The public is often advised that assistance at least doubles cessation rates. But while the clinical trial literature consistently shows higher quit rates from assisted than unassisted cessation, population studies show the opposite. For example, a 1990 US study found 47.5% of those who tried to quit unaided over 10 years were successful, compared with 23.6% using cessation programs.”
To look for any possibly bias, the authors randomly chose 30 papers that considered assisted cessation interventions, 30 that considered unassisted cessation interventions, and 30 that discussed the prevalence of smoking cessation. They then looked to see if any of the papers authors and /or studies had received support from a pharmaceutical company manufacturing smoking cessation products. Their seems to be a heavy possibility of bias, as 12/25 (48%) of pharmacotherapy intervention studies, 3/29 (10.3%) of nonpharmacotherapy intervention studies, and 0/30 of unassisted cessation studies had at least one author declaring support from a company manufacturing cessation products and/or research funding from such a company (p<0.001).
If you are a smoker, the fact that quitting is good for your health remains uncontested. How you quit may be strongly influenced by the pharmaceutical companies who make the smoking cessation drugs. It is important to remember that quitting cold turkey is always an option and is not necessarily difficult and will not cost you a dime.
Chapman S, MacKenzie R (2010) The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences. PLoS Med 7(2): e1000216. doi:10.1371/journal.pmed.1000216