Malgré qu’elle n’est pas la première étude qui trouve que les substituts nicotiniques n’ont pas plus d’efficacité que du placebo pour arrêter de fumer, les résultats d’une étude récente de Harvard a eu l’effet d’une bombe dans le milieu anti-tabac et pharmaceutique. Comment est-ce que Harvard, en l’occurrence le co-auteur Greg Connolly, un anti-tabagiste notoire, a pu publier une telle étude qui remet en question tout le dogme de la dépendance à la nicotine et qui peut compromettre de décennies de recherches et des politiques sur le tabac?
Pour notre part nous nous demandons plutôt pourquoi qu’il a attendu six ans après la fin de l’étude pour la publier. En effet, son étude a été complétée en 2006 et a été rendue publique en 2012. Six ans et beaucoup d’argent dépensé sur des produits inefficaces ont écoulé depuis, pourquoi?
La réponse se trouve peut-être dans le fait que Connolly a donné sa démission auprès du FDA en tant que conseiller scientifique au tabac à la fin de l’année 2010 pour des raisons pas trop clairement exprimées mais qui laissent entendre qu’il avait des différents avec certaines opinions et politiques du FDA et qu’il considérait que son ouvrage était susceptible d’avoir plus de valeur de l’extérieur plutôt que de l’intérieur de cette organisation . Lire FDA loses two top members . Cela en dit long sur les politiques du FDA et la liberté des scientifiques de s’exprimer ouvertement.
Si les produits nicotiniques sont inefficaces et plusieurs études avant celle-ci le confirment aussi, nous revenons à ce que le Pr. Molimard dit depuis longtemps – la nicotine seule n’est pas la substance qui rend les fumeurs dépendants. Il a par ailleurs publié un autre article à cet effet en réaction à cette étude que nous vous invitons à lire à : Patches et gommes à la nicotine ne servent à rien
Voici l’étude (en anglais) de Harvard : A prospective cohort study challenging the effectiveness of population-based medical intervention for smoking cessation
A bad time for a bad obesity prediction
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All you have to do to produce an obesity forecast that will be published in
a medical journal is draw a straight line through the recent past and push
it...
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I trust that you do not mind if I comment in English! I can still read French quite well, but the vocabulary is very iffy.
I have just read a little of study which you quote. Here is the 'conclusion' as per the abstract:
Conclusions: This study finds that persons who have
quit smoking relapsed at equivalent rates, whether or not
they used NRT to help them in their quit attempts.
Cessation medication policy should be made in the larger
context of public health, and increasing individual
treatment coverage should not be at the expense of
population evidence-based programmes and policies.
Let's just divide that statement into its two main parts:
1. Whatever aid people used to quit smoking, they relapsed at the same rate.
2. That, as a result of the bad record of NRT, it is necessary to continue, or even increase, persecution.
We must note what the conclusion did not say, which should have been that NRT should be abandoned in view of the fact that it is ineffective. Instead, the authors chose to emphasise, illogically, that this is a reason to continue such therapy and, at the same time, tighten the persecutory screw.
But note this quote from a subsequent section of the study (next page): Other representative population studies have also found no beneficial effect of the use of nicotine replacement therapy (NRT) on quitting success or long-term abstinence compared with unaided cessation. Note that what this statement DOES NOT say, which is that unaided cessation is far, far more successful! It merely says that NRT is no more successful than just will-power. It does not say, which it should, that will-power is far, far more effective. It seems to me that the authors were trying to edge their bets in order not to upset Tobacco Control.
No wonder that Tobacco Control hid this study! It clearly states that NRT is a waste of time and money, since no form of NRT is better than quiting without help of any kind.
This bears out my own thinking. Smoking is essentially a habit. As a habit, it is hard to break because, essentially, it is an 'anytime, anywhere' habit. That is, it is an 'all-day-long' habit, with overtones of 'withdrawal symptoms' (of a chemical kind) when a person decides to quit. That is, it might be easy to break the habit of smoking while in an airport waiting for a flight (which I have found easy to do on a temporary basis) on three or four occasions in the year, but much more difficult to break the habit whilst I am writing this. In fact, I am not sure that I could write this if I was not smoking!
One day, there will be a reckoning, and it will not be favourable to Tobacco Control.
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