My idea of a "novel approach" is not using the same old stuff!

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Vocalek

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Arch Intern Med -- Abstract: Nicotine Therapy Sampling to Induce Quit Attempts Among Smokers Unmotivated to Quit: A Randomized Clinical Trial, November 28, 2011, Carpenter et al. 171 (21): 1901

Background
Rates of smoking cessation have not changed in a decade, accentuating the need
for novel approaches to prompt quit attempts.


Methods Within a nationwide randomized clinical trial (N = 849) to
induce further quit attempts and cessation, smokers currently unmotivated to
quit were randomized to a practice quit attempt (PQA) alone or to nicotine
replacement therapy (hereafter referred to as nicotine therapy), sampling within
the context of a PQA. Following a 6-week intervention period, participants were
followed up for 6 months to assess outcomes. The PQA intervention was designed
to increase motivation, confidence, and coping skills. The combination of a PQA
plus nicotine therapy sampling added samples of nicotine lozenges to enhance
attitudes toward pharmacotherapy and to promote the use of additional cessation
resources. Primary outcomes included the incidence of any ever occurring
self-defined quit attempt and 24-hour quit attempt. Secondary measures included
7-day point prevalence abstinence at any time during the study (ie, floating
abstinence) and at the final follow-up assessment.

Results Compared with PQA intervention, nicotine therapy sampling was
associated with a significantly higher incidence of any quit attempt (49% vs
40%; relative risk [RR], 1.2; 95% CI, 1.1-1.4) and any 24-hour quit attempt (43%
vs 34%; 1.3; 1.1-1.5). Nicotine therapy sampling was marginally more likely to
promote floating abstinence (19% vs 15%; RR, 1.3; 95% CI, 1.0-1.7); 6-month
point prevalence abstinence rates were no different between groups (16% vs 14%;
1.2; 0.9-1.6).
Conclusion Nicotine therapy sampling during a PQA represents a novel
strategy to motivate smokers to make a quit attempt.

Compare this to the results Dr. Polosa achieved using e-cigarettes with people who were not willing to quit smoking:

Thirteen of 40 (32.5%) of the participants sustained a 50% reduction in the
number of cigarettes per day (CPD) at week-24, with their median of 25 CPD
decreasing to 6 CPD. A sustained 80% reduction was shown in five (12.5%)
participants, with their median of 30 CPD decreasing to 3 CPD. Sustained smoking
abstinence at week-24 was observed in nine (22.5%) participants, with six of
them still using the e-cigarette by the end of the study. Combined sustained 50%
reduction and smoking abstinence was shown in 22 (55%) participants, with an
overall 88% fall in CPD.

Electronic cigarettes help to reduce cigarette smoking
 

Tom09

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Useful comments on this study (Carpenter et al. 2011) also by Michael Siegel and ACSH.

Some things about this study are just incredibly odd. First it is this strange sample group “unmotivated to quit” but willing to commit to a “practice quit attempt”. Second is that the outcome became touted like “A Little Nicotine Delivers Big Results”, when 6-month abstinence rates are simply identical (~ 15 %).

Note, there is a labeling issue when we compare the sample definitions “unmotivated/unwilling to quit” of both, the Carpenter et al. 2011 and the Polosa et al. 2011 studies mentioned in OP. Willing to commit to a “practice quit attempt” (quit but not necessarily intended forever) and willing to change smoking pattern and/or to reduce is not the same. Also, Carpenter is hands on, Polosa is hands off. Thus, results don’t compare directly. Polosa et al. would compare directly to studies like this (hands off, giving out pharmaceutical NRT products to smokers unwilling to quit - but willing change smoking pattern and/or to reduce - induced 6-month abstinence of ~7 %, twice the rate of placebo) And of course, Polosa’s “unwilling to quit” pilot study already hit the ballpark of what can be achieved on a population “willing to quit” with conventional NRT.
 

Ande

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The purpose of this study, and the reason for its odd, slanted, conclusion:

to enhance attitudes toward pharmacotherapy

Not to put too fine a point on it, but this isn't a study, it's a commercial.

If it were a study, it would have concluded: "Nicotine sampling therapy leads to experimentation with quitting, but ultimately does not increase quitting rates amongst smokers without previous motivation to quit."

Best,
Ande
 
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rolygate

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I think the basic problem is it's too easy to get research grants for just about anything, for those with the right connections - and probably very hard if you don't have the connections, even for valuable work.

The idea that someone can get $0.85m for something completely, totally and utterly useless to anyone anywhere, such as the recent YouTube research, is mind-boggling. It is to be hoped that it all came from pharma sources, and not one cent was diverted from something that could do some good. A forlorn hope, probably.
 
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