Do Proactive Measures by Doctors Aid in Smoking Cessation?

The rates of cessation were very low at six months. They were slightly (though not significantly lower) in those offered enhanced support by comparison with standard support, and those offered nicotine patches were lower still. Moreover, the rates of cessation were half of the self-reported rate when measured objectively by the level of exhaled carbon monoxide -- in other words, about half those who self-reported cessation were not telling the truth.

Overall, about 8 percent of the people enrolled in the trial had quit smoking at six months, 6.6 percent of those offered patches, and 9.4 percent not offered patches. When one considers that only 3.44 percent of people who called the help line were willing even to enter the trial, this is not impressive: not more than 0.28 percent of the people who first called.

Personally I do not find this in the least surprising. It is mistaken to treat a voluntary behavior as if it were a disease, and then try to "treat" it. The editorial that accompanied the research paper, written by an Australian professor of public health and a director of a center for "behavioral research, was rather saddened by the result. "Although motivation to quit by itself is often insufficient too, most ex-smokers finally seem to quit without professional or pharmaceutical assistance."

In other words, people who say they want to quit don’t always mean it; but millions have meant it, and have succeeded, no thanks to doctors. And those doctors who simply told their patients to "pull yourself together" were actually right by comparison with those who held that addiction to smoking was a chronic relapsing brain disease. They had a much more sophisticated grasp of the human condition.