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Little evidence to support assertion in U.S. News story that ADHD drugs can help smokers quit

Rating

3 Star

ADHD Stimulants Might Help a Smoker With the Disorder Cut Back on Cigarettes

Our Review Summary

This US News & World Report story discusses the possibility that some drugs used mainly to control attention deficit hyperactivity disorder (ADHD) may be useful in helping people quit smoking.

The story focuses on a very small pilot study where researchers claim an ADHD drug, lisdexamfetamine dimesylate, reduced the number of cigarettes a person smoked, although it had no effect on stopping their smoking habit. The story doesn’t mention either the cost of the drug nor any harms that might come from its use. It also doesn’t  provide enough information about the study itself for readers to adequately evaluate its results. Nor does it disclose that the study was funded by a pharmaceutical company and that some members of the research team receive support from pharmaceutical firms.

 

Why This Matters

Smoking is a serious addiction that causes serious health consequences in those with and without ADHD, so efforts to promote abstinence and decreased use are appropriate. But when it comes to the ADHD drug Vyvanse helping smokers quit, this article is much ado about nothing.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There is no mention of the cost of the drug mentioned in the study, lisdexamfetamine dimesylate, in this story. A quick web search provided costs for a 30-day supply ranging from $285 to $337.

Nor was there any mention of whether health insurance would cover the cost of this drug for helping curb smoking, especially since this is an “off-label” usage.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story states that, “our findings suggest that among adult regular smokers with ADHD who are interested in quitting, LDX does not increase the probability of smoking cessation more than does placebo, but is associated with a significant overall reduction in the amount of cigarettes smoked and is effective for reducing ADHD symptoms.”

However, there are no numbers offered to lend context to that statement. We don’t know how many cigarettes participants smoked on average, nor do we know how many fewer they smoked while on the drug.  Basically, there no numerical data provided in this story.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story doesn’t mention anything about harms, potential or reported, to those taking lisdexamfetamine dimesylate. While some known side effects may be considered minor, this is an amphetamine-based compound and appropriate cautions should be mentioned.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

While the story does explain that participants were given either the drug or a placebo, nothing else was offered to help evaluate the study design, and thus put its findings into perspective. The study itself was very small, involving less than two dozen participants in either the placebo or experimental group. The study offered several limitations which went unmentioned by the news story:

“First, our sample size was quite small and this study can thus only be considered a pilot trial. Most of our findings did not even approach significance, however, suggesting that statistical power (i.e., sample size) was not a major factor in our findings.”

“Second, we did not collect systematic follow-up data on our sample after the end of treatment.” … “It would have been useful to assess the impact of LDX on smoking-related outcomes over a longer duration of time.”

Does the story commit disease-mongering?

Satisfactory

While the story doesn’t really commit disease mongering, it does play off the understanding that a large portion of the smoking population wants to quit and are therefore easily susceptible to any information suggesting an easier remedy to stopping smoking, which this story does. The headline makes it sounds like it was about using ADHD drugs as smoking cessation treatment, for example.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

While the story includes a comment from a physician not affiliated with the study mentioned, it fails to point out that some members of the research team receive support from pharmaceutical firms, or that the study itself was underwritten by a drug company.

Does the story compare the new approach with existing alternatives?

Satisfactory

We’ll give the story a just barely satisfactory here since it includes the information that study participants also were using a transdermal patch aimed at helping them quit smoking. It also mentions two other available drugs which may be useful in helping curb smoking.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The drugs mentioned in this story are all currently available.

Does the story establish the true novelty of the approach?

Not Applicable

The story appears to be a feature story vs pegged to a new study being published. So we’ll give this an N/A.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not appear to rely on a news release.

Total Score: 4 of 9 Satisfactory

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