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Critique of Ferguson et al, BMJ 2012 Ron Borland PhD The Cancer Council Victoria

Critique of Ferguson et al, BMJ 2012 Ron Borland PhD The Cancer Council Victoria. The sample. Already called the Quitline Clinical not population perspective Quit attempt 4-days to 4 weeks ? One in five interested in getting help Not told in consort diagram Excludes those ‘hot to trot’.

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Critique of Ferguson et al, BMJ 2012 Ron Borland PhD The Cancer Council Victoria

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  1. Critique of Ferguson et al, BMJ 2012 Ron Borland PhD The Cancer Council Victoria

  2. The sample • Already called the Quitline • Clinical not population perspective • Quit attempt 4-days to 4 weeks • ? One in five interested in getting help • Not told in consort diagram • Excludes those ‘hot to trot’

  3. Problems • Poor reporting on differential use of help • No length of call data • Ignores initial counselling call • No clear indication of difference in actual help received • less than one counselling session more for ‘proactive’ • Poor data on meds use • No data on making quit attempts

  4. Possible effects of the NRT offer • Delay in getting the NRT and greater delay in quit attempt • Loss of the ‘Right’ moment • Possibility that those not bothering to call also less likely to try than other non-NRT users • No mediational analysis • Cant infer effect of NRT

  5. Interpretation • That callers did not accept calls • No evidence provided • That counsellors tend to offer what they feel is needed not consided • That this is a representative sample of Quitline callers • It is not

  6. What I take from the study • Neither offer of NRT or extra support calls helped among those who had set a quit date 4-28 days in advance • My study (Segan & Borland, 2011) showed that trying to add extra calls was hard also, and showed no effect with a larger difference in number of calls • No evidence that more intensive counselling works – beyond Standard • We need to understand why

  7. Implications (Continued) • But wrong time to offer NRT • Aim is to encourage quitting and calling: • Evidence shows that it does this • Barriers to offer of NRT may make it counterproductive • Careful of the one study conclusion when different to that of the bulk of existing literature

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