Monthly Archives: November 2014

Working Paper: Phillips-Nissen-Rodu, Understanding the evidence about the comparative success of smoking cessation methods: choice, second-order preferences, tobacco harm reduction, and other neglected considerations

[Update 22feb15: A new version is now available: Phillips-Nissen-Rodu Smoking or quitting Neglected considerations (pdf). There is a major change in title, to “Smoking or quitting: choice, true preferences, tobacco harm reduction, and other neglected considerations”, but it is still an improved version of the same paper.

Acknowledgements for helpful suggestions that contributed to the new version to Oliver Kershaw and other participants in an ECF discussion ( and Frank Baeyens.

Comments are still welcome. We will be submitted this version but should have a chance to incorporate new suggestions.


Our new working paper is available for download here: Phillips-Nissen-Rodu Understanding the evidence about cessation methods. [Update: link to obsolete version removed]

Abstract:  The extensive literature on methods people use to quit smoking is almost always interpreted in naïve and unhelpful ways. This is partially due to treating smoking cessation as if it were medical disease treatment, despite the fundamental differences. The main problem, however, seems to be a failure to recognize what it means when someone indicates they want to quit smoking. An understanding of the preferences that motivate smoking and cessation allows us to categorize would-be quitters, particularly identifying the difference between first- and second-order preferences for quitting. This demonstrates the absurdity of attempts to determine what cessation method is “best” or even “better”, as well as explaining the frequent failure of medical interventions. This analysis offers advice for both readers of the research and those who wish to quit smoking.

We believe this is a very important paper. Catherine and I have been mulling over the crux of it for literally five years and the three of us have been working on this version of it for about a year. It potentially explains a lot about why smoking cessation efforts are generally failures and smoking cessation policies are even worse. If this were taken seriously, it could really make a big difference.

En passant, the analysis has some other interesting implications. It shows that NRTs are not nearly the failure they appear to be — so long as you properly understand what is reasonable to ask of them. (I gave a talk on this material emphasizing that point to a pharma industry associated audience last week; slides are here if you are interested. Note that this does not include all the key points from the working paper.) Similarly, the analysis points out other disconnects between what happens in practice versus what happens in experimental models or other research.

Comments welcome, either here in the comments section or via email or other media.