Keywords Behavioural treatment, bupropion, methodology of clinical trials, psychological treatment, smoking cessation.

Firstof all,wewouldliketothankDrHajekforprovidingsuchclosescrutinyof ourresearch[1]andforsuggestingthat our research be replicated [2], a suggestion we mostenthusiastically welcome. We also endorse Dr Hajek’ssuggestion to follow up the Psychodynamic ModelTrain-ing (PDM) subjects; in fact, we also suggest a follow up ofthe Zyban subjects and all subjects of either group forgood measure, by an independent researcher.From the beginning of the trial, most of us were con-cerned about recruitment bias favouring a novel psycho-therapyasopposedto‘justanothermedication’andtriedas best as we could to counteract any possible mediahype of the psychotherapeutic intervention. As Dr Hajekpoints out, the second recruitment announcement wasindeed much less biased than the ﬁrst. Indeed, out of concern for a possible recruitmentbias, we performed the completers’ analysis, pursuinga line of argument that Dr Hajek endorses. With respectto the alleged uniqueness of our 3-month results, were-emphasize that continuous abstinence was deﬁnedstrictly according to the Russell Standard as detailed byWestandcolleagues[3]andthatinthatverysamepaper,‘point prevalence’ is repeatedly deﬁned as ‘at the time ofthe follow-up’, i.e., without giving any speciﬁed observa-tion period [3]. In our trial, subjects were ﬁrst contactedby telephone and asked about their smoking status. Theoverwhelming majority of the relapsers we contactedrefusedtoprovideanyfurtherinformationwithrespecttotheexacttimecourseof theirrelapse.Therefore,continu-ous abstinence and point prevalence abstinence are, ofcourse, identical at the 3-month time point, i.e., at theﬁrst follow-up interview.Whatever the recruitment bias and the uniquenessof the trial centre interventions in Graz may havebeen,recentlargerandomizedcontrolledclinicaltrialsbyJorenby and colleagues, on which our trial was closelymodelled for easier comparison, and in which minimumnon-pharmacological therapeutic interventions wereoffered, even intention-to-treat (ITT) 12-month continu-ous abstinence rates for sustained-release bupropionwere18%intheir1999trial[4],and15%intheir2006trial[5],i.e.,notthatmuchdifferentfromthe12%of ourtrial.The reference of Dr Hajek to ‘Mommy and I are one’,while a sure-ﬁre way to get laughs from some of thereaders,suggestsaslightdisrespectforthedeﬁcitsinself-assertiveness,self-worth,anddeﬁcitsinmemoryrecallofloving and satisfying relationships that many substancedependent individuals and, indeed, many of us, sufferfrom.Frommyownexperienceasaneedyindividualanda psychotherapist, I can assure Dr Hajek that these deﬁ-cits cannot be underestimated. Now it turns out that apsychotherapeutic intervention that boldly addressesthese needs and deﬁcits (the obscene and the shameful)and does so in a psychotherapeutic climate where otherpsychotherapeutic schools clothe their approach in analoof and inaccessible jargon to avoid being called‘unscientiﬁc’—seems to have been efﬁcacious. Veryefﬁcacious. Scientiﬁc method and time will uncover thetruth—let us all try to replicate this research in a multi-centre trial, preferably in a number of culturally andlinguistically diverse countries, and let us study whichneurobiological changes accompany the successfulcompletion of these ‘annoyingly’ efﬁcacious psycho-therapeutic approaches.