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John R. Hughes, MD
The University of Vermont Burlington

JAMA. 1989;262(6):774.

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In Reply.—

Dr Jacobson implies that if our sample size were adequate we would have shown an effect of nicotine gum. We would remind our readers that the 2% to 5% increases in quit rates with nicotine gum in our study were not reliable. In addition, if one uses meta-analytic techniques¹ to combine the results from ours and the two prior studies with 1-year follow-ups^2,3 to increase the sample size, the combined results do not show a significant difference between nicotine and placebo gum. To detect a small increase in quit rates with adequate power (β =.80) and a conservative type II error (a =.05) would require very large sample sizes (eg, 2840 for the 7% vs 10% difference reported in our trial) and this is why we decided not to try to detect such a difference.⁴

Dr Jacobson states that more intensive treatment and follow-up increase quit . . . [Full Text PDF of this Article]

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