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Nicotine Gum and Skin Patch Face New Doubt


4 Star


Nicotine Gum and Skin Patch Face New Doubt

Our Review Summary

We applaud the writer for being the only one of the three to find comments from researchers not connected to the makers of nicotine products. But we wish that the independent commentary had been used to better effect to actually help readers understand the strength of the evidence.


Why This Matters

This story was the only one to note that the clinical trials that are mentioned in all three stories have been the basis for federal guidelines that recommend the use of nicotine replacement products as aids for quitting smoking. One of the surest ways to reduce premature death in the US and around the world would be to effectively encourage people to reduce smoking, and federal guidelines do make a difference in the paths that individual physicians choose for their patients and in the programs that are funded. If evidence is starting to build that nicotine products are less effective than previously thought, these guidelines and the resulting funding strategies may need to be reexamined.


Does the story adequately discuss the costs of the intervention?


All three stories at least mentioned the total amount of money being spent on nicotine replacement products or the growth in that spending. None of the stories actually explained how much these products cost or compared them to the costs of cigarettes. The cost of an 8-week regimen of nicotine patches is $160-200.

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

Not Satisfactory

The story was less successful than the other two in quantifying the benefits. It did not put any hard numbers to the findings, saying instead, “At each stage, about one-third of the people trying to quit had relapsed, the study found. The use of replacement products made no difference, whether they were taken for the recommended two-month period (they usually were not), or with the guidance of a cessation counselor. One subgroup, heavy smokers (defined as those who had their first cigarette within a half-hour of waking up) who used replacement products without counseling, was twice as likely to relapse as heavy smokers who did not use them.” While using vague terms like “twice as likely” may make the story a little less daunting for some readers, we think that a story on a scientific study, especially a study as controversial as this one, should provide the actual numbers from the study as much as possible. Also, all three stories failed to make it clear whether the same 30% or so of people continued to relapse throughout the study or whether a total of two-thirds of the participants fell back to smoking.

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

Not Satisfactory

None of the stories mentioned the potential harms from taking nicotine, as opposed to quitting cold turkey. Nor did they mention the additional risks associated with continuing to smoke instead of making use of a more successful smoking cessation program that would actually help a smoker quit. As the leading risk factor for early death, smoking should be stopped as quickly and effectively as possible.

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


As with the other two stories, this one provided the basic outlines of the study protocol, but, unlike the other two, it did not provide more than make a vague mention of a potential flaw in the study’s design. None of the stories, either, made any attempt to discuss whether the previous evidence in favor of nicotine products could have been unduly influenced by the makers of the products.

We did appreciate, though, that this story noted that earlier studies had shown “the products have proved effective, making it easier for people to quit, at least in the short term.”  This places the current study into perspective since it looked at long term outcomes at 5 years.

We could go either way with this score, but we’ll give it the benefit of the doubt.

Does the story commit disease-mongering?


No disease mongering.

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


This is the only one of the three stories we reviewed that did not quote someone directly connected to GlaxoSmithKline, the maker of some of the best selling tobacco replacement products. Several independent sources were quoted.

Does the story compare the new approach with existing alternatives?


The story lists a range of alternative factors for successful smoking cessation at the end of the piece: “Motivation matters a lot; so does a person’s social environment, the amount of support from friends and family, and the rules enforced at the workplace. Media campaigns, increased tobacco taxes and tightening of smoking laws have all had an effect as well.” This isn’t quite a comparison with nicotine products, but we give the story credit for covering some of this territory.

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


This story talks about the sales figures for nicotine products as one indication of widespread availability and use.

Does the story establish the true novelty of the approach?


The story does a great job pointing out how this study fits into the recent history of similar research into the topic.

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


The story did not rely on any press release.

Total Score: 8 of 10 Satisfactory


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