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Attributes of Interventions That Stop Smoking-Reply

Thomas E. Kottke, MD; Renaldo N. Battista, MD, ScD; Gordon H. DeFriese, PhD; Milo L. Brekke, PhD
JAMA. 1988;260(11):1552. doi:10.1001/jama.1988.03410110060015.
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In Reply.—  We appreciate Mr O'Donnell's interest in our article. We, however, must disagree that limiting the analysis to studies with a control group "severely limits the sample size and makeup" of smoking intervention trials, since two of the largest studies ever carried out1,2 were randomized trials. Increasing sample size can neither correct for systematic bias in a study design nor eliminate the need for a control group.We are also uncomfortable with the implication that evaluating the effects of therapy diverts resources from treatment. Barnes3 has noted that worthless surgical procedures persist because of this same argument. We would postulate that careful evaluation actually preserves resources by eliminating the expenditure of resources on worthless or harmful therapies.Our analysis would predict that the smoking cessation program described by Mr O'Donnell4 would be highly successful. The intervention included group counseling with multiple types of interventions available to


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