Attributes of Interventions That Stop Smoking

To the Editor.—  I read with great interest the article by Kottke et al¹ entitled "Attributes of Successful Smoking Cessation Interventions in Medical Practice: A Meta-analysis of 39 Controlled Trials" in the May 20 issue of JAMA. If we are to enhance our ability to help smokers quit, we need to know the characteristics of successful smoking cessation programs. This article, which is generally well written and based on solid analysis, makes an ambitious effort in that direction and provides conclusions that deserve further attention. However, the conclusions must be viewed with skepticism for at least two reasons.First, while the requirement to limit the analysis to studies with a control group is understandable given that controlled studies generally produce higher-quality scientific evidence than noncontrolled studies, this severely limits the sample size and makeup and makes one wonder if it is representative of all high-quality smoking cessation efforts. The