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Critique of Ferguson et al, BMJ 2012 Ron Borland PhD The Cancer Council Victoria. The sample. Already called the Quitline Clinical not population perspective Quit attempt 4-days to 4 weeks ? One in five interested in getting help Not told in consort diagram Excludes those ‘hot to trot’.
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Critique of Ferguson et al, BMJ 2012 Ron Borland PhD The Cancer Council Victoria
The sample • Already called the Quitline • Clinical not population perspective • Quit attempt 4-days to 4 weeks • ? One in five interested in getting help • Not told in consort diagram • Excludes those ‘hot to trot’
Problems • Poor reporting on differential use of help • No length of call data • Ignores initial counselling call • No clear indication of difference in actual help received • less than one counselling session more for ‘proactive’ • Poor data on meds use • No data on making quit attempts
Possible effects of the NRT offer • Delay in getting the NRT and greater delay in quit attempt • Loss of the ‘Right’ moment • Possibility that those not bothering to call also less likely to try than other non-NRT users • No mediational analysis • Cant infer effect of NRT
Interpretation • That callers did not accept calls • No evidence provided • That counsellors tend to offer what they feel is needed not consided • That this is a representative sample of Quitline callers • It is not
What I take from the study • Neither offer of NRT or extra support calls helped among those who had set a quit date 4-28 days in advance • My study (Segan & Borland, 2011) showed that trying to add extra calls was hard also, and showed no effect with a larger difference in number of calls • No evidence that more intensive counselling works – beyond Standard • We need to understand why
Implications (Continued) • But wrong time to offer NRT • Aim is to encourage quitting and calling: • Evidence shows that it does this • Barriers to offer of NRT may make it counterproductive • Careful of the one study conclusion when different to that of the bulk of existing literature