L Bauld, J Chesterman, K Judge, E Pound, T Coleman

Impact of UK National Health Service smoking cessation services: variations in outcomes in England
Tob Control 2003; 12: 296-301 [Abstract] [Full text] [PDF]

g.sutherland{at}iop.kcl.ac.uk Gay Sutherland

Bauld et al (2003) report a number of interesting results from the evaluation of the NHS smoking cessation services. One result in particular which warrants further investigation is the finding that 4 week success (quit) rates were higher for smokers treated in groups compared to those receiving individual support sessions. The authors briefly discuss possible explanations for this, including the possibility that the former treatment is likely to be offered by more experienced specialist staff. While this may well be true, I believe a far more likely explantion for the difference in success rates is due to selection bias as this was not a randomised study. Smokers with mental health ot other severe psycho-social problems, including drug or alcohol misuse, are usually deemed unsuitable for smoking cessation group programmes. Published research indicates that these smokers tend to be highly nicotine dependent and to have greater difficulty quitting whatever the treatment offered. The difference in success rates between groups and individual counselling might, therefore, simply reflect the two different populations being treated.