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Stephen P. Fortmann, MD; Joel D. Killen, PhD
Stanford University Center for Research in Disease Prevention Palo Alto, Calif

JAMA. 1990;264(12):1531.

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In Reply.—

Dr Hughes oversimplifies the research on nicotine replacement in smoking cessation in his letter comparing his study¹ with ours.^2,3 Two factors are critical to the effectiveness of nicotine replacement: an adequate dose (compliance) and concomitant psychological intervention. Dr Hughes did not report compliance to nicotine gum in his study; our structured, 8-week, self-administered psychological program was not "brief physician advice." Comparing these two studies is therefore difficult, but we will comment on some of Dr Hughes' conclusions.

While analyses of our full study did not show main effects at 12-month follow-up, they did confirm the finding published in JAMA² that the combination of that program and nicotine replacement was effective at 6 months. We also found a nicotine gum effect at 12 months among men but not women. While this sex difference was a post hoc finding, Dr Hughes may be too hasty in dismissing . . . [Full Text PDF of this Article]

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