A Commentary re Quitting activity and tobacco brand Switching: findings from the ITC‐4 Country Survey

• Published in: Australian and New Zealand journal of public health 2015-04, Vol.39 (2), p.114-115
• Main Author: Caldwell, Brent
• Format: Article
• Language: English
• Subjects: Decision making; Female; Humans; Intention; Male; Marketing; Public health; Smoking; Smoking - psychology; Smoking Cessation - statistics & numerical data; Surveys; Tobacco; Tobacco Products - statistics & numerical data; Tobacco Use Disorder - psychology
• ISSN: 1326-0200; 1753-6405
• DOI: 10.1111/1753-6405.12380

Cowie and colleagues have reported the results of their analysis of quitting activity and brand switching in data collected from the International Tobacco Control Four Country Survey (ITC-4) to determine whether smokers’ interest in quitting, and their quitting behaviour, influences their decision to switch brands, or whether the reverse is true.1 The ideal method to test the causal direction of associations between switching brands, making an attempt to quit, and quit success would be to conduct a randomised controlled trial (RCT). RCTs ensure factors that potentially confound the relationship between the putative cause and the putative outcome are removed from the equation, since they are (on average) equally distributed between people who are exposed to the putative cause and those who are not. Furthermore, treatment allocation in RCTs is controlled by the researchers, thereby removing treatment selection bias. However, use of a randomised controlled trial to assess the role of switching brands is fraught with difficulties. Would it be ethical to randomise people to either switch brands or continue to smoke their usual brand?