Conflicts of Interest with Big Pharma

Friday, April 03, 2009, New Study Demonstrates How Conflicts of Interest with Big Pharma Influence Reporting of the Effectiveness of Drug Treatment
A new study published online ahead of print in BMJ reviews the evidence on the effectiveness of nicotine replacement therapy (NRT) in smoking cessation and concludes that: “Available trials indicate that nicotine replacement therapy is an effective intervention in achieving sustained smoking abstinence for smokers who have no intention or are unable to attempt an abrupt quit.” (Moore D, Aveyard P, Connock M, Wang D, Fry-Smith A, Barton P. Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis. BMJ 2009;338:b1024 doi:10.1136/bmj.b1024).

The article is based on a review and meta-analysis or nicotine replacement therapy treatment of smokers who were unable or unwilling to stop smoking abruptly. The outcome was continuous abstinence from smoking which was generally measured at six month and twelve month follow-up. A secondary outcome was sustained smoking reduction, which was defined as reducing cigarette consumption by more than 50%.

The results were as follows:

The proportion of smokers achieving sustained abstinence at six months with nicotine replacement therapy was 6.75%, compared to 3.28% for placebo, yielding a significant relative risk of 2.06.

The proportion of smokers achieving sustained abstinence at final follow-up (generally one year) was 1.6% for the nicotine replacement therapy group, compared to 0.4% for the placebo group.

The proportion of smokers achieving sustained reduction at six months was 21.8% in the intervention group compared to 16.5% in the placebo group.

The proportion of smokers achieving sustained reduction at final follow-up was 6.3% for the NRT group and 1.6% for the placebo group.