2009-07-11 21:06:51 - Freedom2Choose, working with hypnotherapist Chris Holmes, reveals that the continued use of the Department of Health’s claim “you are up to four times more likely to quit with NHS help” has no evidential basis. Freedom2Choose can show that the Department of Health routinely uses misleading statements to promote Nicotine Replacement Therapy (NRT) products as its preferred method of treatment for smoking cessation. This promotion is a very costly exercise, at a time of imminent cutbacks to public services.

Belinda Cunnison, of pro-choice group Freedom2Choose, investigated the common claim that you are “four times more likely to quit with NHS”, which is used in most promotional materials for NRT products, and frequently in press releases on the subject of smoking cessation. “I traced this claim to a Department of Health web page,(1) which also claimed a 15 per cent success rate at 12 months for NRT. The evidence that was supposed to demonstrate this 15 per cent success rate and the ‘four times more likely to quit’ phenomenon was not listed in the footnotes, so I wrote to the Department to ask for it.”

It took over three months to get the information. The following reports were made available by

Cameron Gordon of the Department of Health in relation to smoking cessation studies:

• The Ferguson Health Inequalities Reduction Paper(2)
• The Evaluation Report(3)
• The Shiffman Report(4)
• The Cochrane Reviews(5)
• The Hughes Report(6)
• The Borland Report(7)

The documents revealed neither a 15 per cent quit rate at 12 months, nor any evidence that quitting with the NHS is four times more effective than willpower alone. The Borland Report recorded a 12-month success rate of 6.5 per cent (higher rates were achieved only in the smaller scale studies), whereas the largest study done on quitting using willpower alone achieved a rate of around 6 per cent.

“On the government’s own evidence, the claim ‘up to four times more likely to quit with the NHS’ is completely untrue. How can this claim be justified?” continues Belinda Cunnison. “The use of NHS treatments makes almost no difference at all to quitting success. A recent study published in the British Medical Journal(8) has also documented the long-term success rate of NRT at a mere 1.6 per cent. The whole exercise is futile as well as being enormously expensive.”

Freedom2Choose also has evidence that General Practitioners are given payments for patients who set a quit date, and an additional payment for patients who remain quit at four weeks. The payments are listed in NHS Warwickshire’s board report, March 2009.(9) This reflects the urgency of smoking cessation on the Trust’s list of priorities – an unfortunate choice of priority since patients seem just as good at giving up smoking under their own volition as they are with NHS help.

“At a time when we need to economise, particularly in the Health Service, why is our Government pumping tax-payers’ money into a failed product and using misleading claims to the service user?” questions Belinda Cunnison. “Will-power alone has a comparable success rate for those who choose to give up smoking. This is a complete waste of our resources.”

Author and hypnotherapist Chris Holmes(10) agrees and states, “We are exposing a systematic and deliberate policy to seriously mislead the public over the true effectiveness of these services. The actual extent of long term failure was being quietly covered up - which we now know from the Borland report is 94 per cent failure at 12 months - whilst four-week results were shamelessly promoted, even including published 'success rates' as high as 90 per cent. Since they knew that to be the exact opposite of the real outcomes, this is a fraudulent misappropriation of hundreds of millions of pounds of taxpayers’ money. NRT simply doesn't work.”

References:
1 NHS Stop Smoking Services & Nicotine Replacement Therapy -
http://www.dh.gov.uk/en/Publichealth/Healthimprovement/Tobacco/Tobaccogeneralinformation/DH_4002192
2 The Ferguson Health Inequalities Reduction Paper -
http://opus.bath.ac.uk/6357/
3 The Evaluation Report -
http://www3.interscience.wiley.com/journal/118739516/issue?CRETRY=1&SRETRY=0
4 The Shiffman Report -
http://tobaccocontrol.bmj.com/cgi/content/abstract/12/1/21
5 The Cochrane Reviews -
http://www.cochrane.co.uk/en/index.html
6 The Hughes Report -
http://www.hospitaldofuturo.com/imagens/Shape%20of%20the%20relapse%20curve%20and%20long-term%20abstinence%20among%20untreated%20smokers.pdf
7 The Borland Report -
http://fampra.oxfordjournals.org/cgi/content/abstract/cmn046
8 British Medical Journal -
http://www.bmj.com/cgi/content/extract/338/apr29_1/b1730
9 NHS Warwickshire, page 7, Appendix 2H -
http://www.warwickshire.nhs.uk/trustboardenclosures/march09/Enc%2016%20Tobacco%20Control%20and%20Smoking%20Cessation%20Board%20Report%20-%20March%202009.pdf - Page 7, Appendix 2H
10 Chris Holmes: Truth Will Out -
http://www.truthwillout.co.uk