Afkicken mét nicotinepleisters leidt tot minder kans op succes
Een recent Australisch onderzoek naar de mate van succes van diverse afkickmiddelen toont aan dat er slechts één methode de meest succesvolle is: Cold Turkey, oftwel zonder enige hulpmiddelen. Ondanks alle propaganda van clubs als Stivoro, de overheid of de farmaceutische industrie zelf kan dit onderzoek maar één feit vaststellen: alle chemische middelen werken veel minder goed dan niet-chemische middelen.
Reden voor de algemenen misvatting dat nicotinepleisters en -kauwgum effectief zijn is, volgens een artikel op whyquit.com, dat de onderzoeken die het succes van de nicotineontwenningsmiddelen vaststelden, (per ongeluk of expres) verkeerd werden uitgevoerd.
Met Cold Turkey valt ook geen geld te verdienen, moeten de farmaceuten gedacht hebben…
Surveys from California (2003), Minnesota (2002), Quebec (2004), London (2003), Maryland (2005), UK NHS (2006) and Australia (2006) all report absolutely no advantage for quitters using pharmaceutical quitting aids over cold turkey quitters. In fact, in a new Australian study among patients of family practice physicians cold turkey was twice as effective as NRT or bupropion (Zyban).
But how can this be? What about those clinical studies the government and its industry partners cite in support of their “double your chances” assertion? What Leavitt, Gerberding, Collins and Husten do not mention is that clinical NRT studies were not blind as claimed.
If they haven’t read a June 2004 study by Mooney, they should. Mooney reviewed 73 allegedly double-blind NRT studies and declared that the limited number of studies assessing blindness were not generally blind as claimed because “subjects accurately judged treatment assignment at a rate significantly above chance.” In other words, a significant number of study participants knew whether they were getting a drug or placebo. This knowledge makes suspect any difference in success rates.
Mooney warned researchers that, “To determine the prevalence of failure, clinical trials of NRT should uniformly test the integrity of study blinds. Moreover, if blindness failure is observed, subsequent efforts should be made to determine if blindness failure is related to study outcome and, if so, to provide an estimate of treatment outcome adjusted for blindness bias. Without these methods and analyses, the validity of NRT clinical trial results could be questioned.”
The blinding analysis in a 2005 study by Dar found that 3.3 times as many placebo group members correctly guessed that they had received placebo (54.5%) as guessed that they had received nicotine (16.4%). Although the Dar study focused on smoking reduction, Tonnesen’s 1993 nicotine inhaler quitting study produced strikingly similar placebo group findings in that 3.8 times as many in the placebo group correctly guessed placebo (58%) as guessed nicotine (15%). Among inhaler users, Tonnesen found that 3.5 times more correctly guessed inhaler (46%) as guessed placebo (13%), while 42% on active and 27% on placebo did not know which treatment they had received.
The blinding problem is especially troublesome because participants were recruited into clinical studies by being told that the study involved evaluation of a “medication.” This recruiting pitch would naturally attract people who want chemical relief from the rising tide of anxieties and craves that their minds associated with withdrawal. For such people, assignment to the placebo group and recognition of full-blown withdrawal led to frustrated expectations.
Despite Mooney’s warning that the validity of clinical studies failing to assess blindness would be subject to question, the five new varenicline studies supporting Pfizer’s Chantix (U.S.) and Champix (Europe) products failed to evaluate blinding, even though placebo group blinding failure concerns were identical to those seen in NRT studies. The varenicline studies indicate that 90% of participants had previously attempted quitting and failed and that nearly 80% of placebo group members relapsed to smoking within two weeks.
