Reduction versus abrupt cessation in smokers who want to quit.

Background\ud The standard way to stop smoking is to quit abruptly on a designated quit day. A number of smokers have tried unsuccessfully to quit this way. Reducing smoking before quitting could be an alternative approach to cessation. Before this method is adopted it is important to determine whether it is at least as successful as abrupt quitting.\ud \ud Objectives\ud 1. To compare the success of reducing smoking to quit and abrupt quitting interventions. 2. To compare adverse events between arms in studies that used pharmacotherapy to aid reduction.\ud \ud Search methods\ud We searched the Cochrane Tobacco Addiction Review Group specialised register, MEDLINE, EMBASE and PsycInfo for topic specific terms combined with terms used to identify trials of tobacco addiction interventions. We also searched reference lists of relevant papers and contacted authors of ongoing trials. Date of most recent search: November 2009.\ud \ud Selection criteria\ud We included randomized controlled trials (RCTs) that recruited adults who wanted to quit smoking. Studies included at least one condition which instructed participants to reduce their smoking and then quit and one condition which instructed participants to quit abruptly.\ud \ud Data collection and analysis\ud The outcome measure was abstinence from smoking after at least six months follow-up. We pooled the included trials using a Mantel-Haenszel fixed-effect model. Trials were split for two sub-group analyses: pharmacotherapy vs no pharmacotherapy, self help therapy vs behavioural support. Adverse events were summarised as a narrative. It was not possible to compare them quantitatively as there was variation in the nature and depth of reporting across studies.\ud \ud Main results\ud Ten studies were relevant for inclusion, with a total of 3760 participants included in the meta-analysis. Three of these studies used pharmacotherapy as part of the interventions. Five studies included behavioural support in the intervention, four included self-help therapy, and the remaining study had arms which included behavioural support and arms which included self-help therapy. Neither reduction or abrupt quitting had superior abstinence rates when all the studies were combined in the main analysis (RR= 0.94, 95% CI= 0.79 to 1.13), whether pharmacotherapy was used (RR= 0.87, 95% CI= 0.65 to 1.22), or not (RR= 0.97, 95% CI= 0.78 to 1.21), whether studies included behavioural support (RR= 0.87, 95% CI= 0.64 to 1.17) or self-help therapy (RR= 0.98, 95% CI= 0.78 to1.23). We were unable to draw conclusions about the difference in adverse events between interventions, however recent studies suggest that pre-quit NRT does not increase adverse events.\ud \ud Authors' conclusions\ud Reducing cigarettes smoked before quit day and quitting abruptly, with no prior reduction, produced comparable quit rates, therefore patients can be given the choice to quit in either of these ways. Reduction interventions can be carried out using self-help materials or aided by behavioural support, and can be carried out with the aid of pre-quit NRT. Further research needs to investigate which method of reduction before quitting is the most effective, and which categories of smokers benefit the most from each method, to inform future policy and intervention development.\ud \u

The Reckless Pursuit of Dominion: A Situational Analysis of the NBA and Diminishing Player Autonomy

This Article examines required genetic testing of NBA players from a situational vantage point, integrating socio-psychological, legal, and ethical analyses. The core argument may be expressed as follows: required genetic testing of NBA players appears consistent with a broader and largely deleterious agenda by the NBA to control players. Since implementation of the rookie wage scale in 1995 through the recent imposition of a paternalistic player dress code, the NBA has increasingly usurped player autonomy. The NBA\u27s capacity to do so largely rests in its adroit manipulation of the situational influences that influence fans and media. For instance, because of unappreciated cognitive biases, fans and media often embrace distorted views of player\u27s maturity, arrest propensity, and collegiate experiences. As a result, NBA players tend to be wrongly identified as immature, out-of-control, and hopelessly uneducated. In turn, the NBA has designed policies that ostensibly remedy these feigned problems while less-detectably transferring autonomy from player to league. In short, the league sees that others often fail to see, and that enables it to surreptitiously control players

A Review of Evaluation Techniques for Social Dialogue Systems

In contrast with goal-oriented dialogue, social dialogue has no clear measure of task success. Consequently, evaluation of these systems is notoriously hard. In this paper, we review current evaluation methods, focusing on automatic metrics. We conclude that turn-based metrics often ignore the context and do not account for the fact that several replies are valid, while end-of-dialogue rewards are mainly hand-crafted. Both lack grounding in human perceptions.Comment: 2 page