NICE relying on flawed data

NICE RELYING ON FLAWED DATA!

PRESS RELEASE

8th FEBRUARY 2008

During correspondence with the National Institute for Clinical Health and Excellence (NICE) on the subject of Allen Carr’s Easyway being specifically excluded by NICE from use by the NHS in the Draft Guidelines for Smoking Cessation issued last year, it became clear that NICE and the rest of the medical establishment, including public health charities ASH and QUIT, are insistent that Allen Carr’s Easyway should conduct a lengthy and hugely expensive Randomized Controlled Trial before being considered for use by the NHS.

NICE has claimed that the vast body of evidence submitted to it demonstrating the popularity, success and effectiveness of Allen Carr’s Easyway method, including two independent studies (*1) conducted by eminent scientists and experts in the field of smoking cessation both of which have been published in peer review journals, is not enough. In particular it has claimed that the two studies are not scientifically robust enough to be accepted as evidence of effectiveness.

NICE and the Government point to the NHS Quit Smoking Service as being a world leader in the field in spite of its appalling success rates which are achieved at enormous cost, financial and human. Everyone, apparently apart from the Government and NICE, knows that the NHS service is not working. Even Robert West, one of its original architects and a former ardent supporter, has admitted “We have lost our way”.

We asked NICE to list the Randomized Controlled Trials they rely on to support their endorsement of theNHS Service. THERE AREN’T ANY!

Instead NICE referred us to the following:

“The cost-effectiveness of the English smoking treatment services; evidence from practice” Godfrey et al Addiction 100 (suppl 2) 70-83

NICE has used this paper to validate its continued endorsement of the NHS Quit Smoking Service, but it is fundamentally flawed.

Allen Carr’s Easyway asked an acknowledged expert in the field of assessing such papers, Dr Anil Visram BSc MB BCh FRCA, to review it and compare it, in terms of robustness, to the two published studies on Allen Carr’s Easyway method (*1) and to review and comment on NICE’s draft guidance in relation to Allen Carr’s Easyway.

We have already asked NICE if the same rigorous tests of reliability had been applied to Godfrey et al as has been applied to evidence supporting Allen Carr’s Easyway.

From Dr Visram’s report, it is clear that little, if any, confidence can be had in Godfrey et al and that a considerably higher degree of confidence can be had in the two studies of Allen Carr’s Easyway method already published in peer review journals but dismissed by NICE.

Allen Carr’s Easyway is not seeking special favours or preferential treatment from NICE. We do however expect a level playing field. It is quite clear that NICE is not currently delivering that. It is inconsistent and inequitable to say that the studies we have submitted are not good enough, yet at the same time rely on other studies which are significantly less scientifically robust.

Summary/Key Points of Dr Visram’s Report:

Regarding: Godfrey et al (2005) The cost-effectivness of the English smoking treatment services: evidence from practice. Addiction, Volume 100, Issue s2

This is the paper that NICE claims supports the NHS stop smoking services.

• The quality of the evidence in this paper is considerably weaker than the quality of the evidence in the two papers (*1) showing a far higher success rate for Allen Carr’s Easyway method.
• One particular concern with the paper is the method by which the primary outcome was measured; a questionnaire filled in by the coordinators of the NHS smoking cessation services.
• It is not possible to have confidence in data collected in this way as it is too subject to bias. It is no different from simply asking Allen Carr’s Easyway smoking cessation coordinators what their success rate is.
• It would be astonishing if this paper were deemed by NICE to be of higher quality evidence than the two papers relating to Allen Carr’s Easyway.

Summary of Dr Visram’s General Comments regardin NICE Draft Guidelines:

* NICE quote studies of by Jonathan Foulds. I have had great difficulty accessing these studies but if, as I have been informed, they are based on two very small samples of 19 patients in one case and 50 in another, that is clearly not enough to reach a sensible conclusion about the effectivness of Allen Carr’s Easyway method.

• I am very surprised indeed that NICE recommends the NHS Quit Smoking Services given that the evidence presented for their effectiveness is so weak and yet specifically names Allen Carr’s Easyway as not recommended despite all the evidence supporting it.
• There is no necessity for Allen Carr’s Easyway to be subjected to the same rigorous analysis as pharmaceutical interventions since there are no side effects and it is harmless and risk-free.
• It seems perverse for the Government and NICE to claim that they are expanding the variety of help available to smokers wanting to quit and giving patients more choice on the NHS and yet at the same time bar Allen Carr’s Easyway which is clearly a very popular and, on the evidence that I have reviewed, also a very effective method of stopping smoking particularly when compared with the alternatives.

End of Summary/Key Points

We very much hope that NICE’s final guidance will reflect the concerns we have raised both in our correspondence and in our formal response to the draft guidance and that the designation of Allen Carr’s Easyway as “not recommended” will be changed. Should that not happen, Allen Carr’s Easyway will be forced very seriously to consider taking legal action via a judicial review.

Notes to Editors/Press/Media:

Dr Visram’s full report is available on request

Robin Hayley, Worldwide Managing Director of Allen Carr’s Easyway is available for comment/interviews. Contact: Press Office jd@statacom.net
07970 88 44 52

(*1)
1) Hutter HP et al. 2006. Smoking cessation at the workplace: one year success of short seminars. Int Arch Occup Environ Health (2006) 79:42-48.
2) Moshammer H and Neuberger M 2007 Long term success of short smoking cessation seminars supported by occupational health care. Addict Behav DOI: 10.1016/j.addbeh.2006.10.002.