#PHTwitJC 17: Paper Summary and Discussion Points

**#PHTwitJC this coming WEDNESDAY**

This month #PHTwitJC is experimenting with a mid-week journal club session!  So please do join us at 8pm this coming Wednesday 22nd August when we will be discussing the following paper…

Effect of offering different levels of support and free nicotine replacement therapy via an English national telephone quitline: randomised controlled trial (2012) J Ferguson, G Docherty, L Bauld, S Lewis, P Lorgelly, KA Boyd, A McEwen and T Coleman

BMJ 2012;344:e1696 doi: 10.1136/bmj.e1696 (Published 23 March 2012)

Paper Summary

Objective: To compare the effects of A) free nicotine replacement therapy versus B) proactive  telephone counselling in addition to standard smoking cessation support offered through a  telephone quitline.

Design: randomised controlled trial of 2591 non-pregnant smokers aged >16 residing in
England who called the quitline between February 2009 and February2010 and  agreed to set a quit date.  648 were each randomised to standard support, proactive support, or proactive support with nicotine replacement therapy, and 647 were randomised to standard support with nicotine replacement therapy.

Main outcome measures: Self reportedsmoking cessa tion for six or more months after the quit date. Also validated cessation by exhaled carbon monoxide measured at six or more months.

Results: At six months, 17.7% (n=229) of those offered nicotine replacement therapy reported smoking cessation compared with 20.1% (n=261) not offered such therapy (odds ratio 0.85, 95% confidence interval 0.70 to 1.04), and 18.2% (n=236) offered proactive counselling reported smoking cessation compared with 19.6% (n=254) offered
standard support (0.91, 0.75 to 1.11).

Author’s Conclusion: Offering free nicotine replacement therapy or additional
(proactive) counselling to standard helpline support had no additional
effect on smoking cessation.

What is a Randomised Control Trial (RCT)?

The randomised controlled trial is considered as the most rigorous method of determining  whether a cause-effect relationship exists between an intervention and outcome.The  strength of the RCT lies in the process of randomisation which is unique to this type of study design.  For a brief introduction to RCT and intervention designs, please visit Health Knowledge

‘Live’ Public Health Twitter Journal Club will take place on Wednesday 22nd August, between 20:00 and 21:00 UK time. To follow and contribute to the discussion, remember to use the #PHTwitJC hashtag

The discussion points for this week are as follows:

  1. Were the aims of the study clearly defined?
  2. Was a randomised-control trial design appropriate to answer this research question?
  3. Were participants appropriately allocated to intervention and control groups?
  4. Could anything else explain these results? (e.g. chance, bias, confounding, truth)
  5. What are the implications of the study for public health practice?
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