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Quitting Smoking: Nicotine vs Placebo Gum-Reply FREE

John R. Hughes, MD
JAMA. 1989;262(6):774-774. doi:10.1001/jama.1989.03430060067020
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In Reply.—  Dr Jacobson implies that if our sample size were adequate we would have shown an effect of nicotine gum. We would remind our readers that the 2% to 5% increases in quit rates with nicotine gum in our study were not reliable. In addition, if one uses meta-analytic techniques1 to combine the results from ours and the two prior studies with 1-year follow-ups2,3 to increase the sample size, the combined results do not show a significant difference between nicotine and placebo gum. To detect a small increase in quit rates with adequate power (β =.80) and a conservative type II error (a =.05) would require very large sample sizes (eg, 2840 for the 7% vs 10% difference reported in our trial) and this is why we decided not to try to detect such a difference.4Dr Jacobson states that more intensive treatment and follow-up increase quit

REFERENCES

Kurtitz SJ, Lanors JR, Koch GG.  A general overview of Mantel Haenzel methods: applications and recent developments . Annu Rev Pub Health . In press.
British Thoracic Society.  Comparison of four methods of smoking withdrawal in patients with smoking related diseases . Br Med J. 1983;;286:595-597.
Campbell IA, Lyons E, Prescott RJ.  Stopping smoking: do nicotine chewing gum and postal encouragement add to doctors' advice? Practitioner. 1987;;231:114-117.
Fleiss JL. Statistical Methods for Rates and Proportions . New York, NY: John Wiley & Sons Inc; 1981;.
Fagerstrom KO.  Effect of nicotine chewing gum and follow-up appointments in physician-based smoking cessation . Prev Med. 1988;;13:517-527.

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Kurtitz SJ, Lanors JR, Koch GG.  A general overview of Mantel Haenzel methods: applications and recent developments . Annu Rev Pub Health . In press.
British Thoracic Society.  Comparison of four methods of smoking withdrawal in patients with smoking related diseases . Br Med J. 1983;;286:595-597.
Campbell IA, Lyons E, Prescott RJ.  Stopping smoking: do nicotine chewing gum and postal encouragement add to doctors' advice? Practitioner. 1987;;231:114-117.
Fleiss JL. Statistical Methods for Rates and Proportions . New York, NY: John Wiley & Sons Inc; 1981;.
Fagerstrom KO.  Effect of nicotine chewing gum and follow-up appointments in physician-based smoking cessation . Prev Med. 1988;;13:517-527.
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To understand the clinical management of acute heart failure syndromes.
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