Community based heart health promotion project in England (1998)

# Self reporting overestimates smoking cessation rates {#article-title-2} EDITOR—Baxter et al state that their community intervention led to a 6.9% difference in smoking rates.1 Quitting was defined by self report in questionnaires. In previous studies, reported smoking cessation has been reduced when self reporting has been checked against biochemical markers. For example, in the OXCHECK study 30% of those who reported having stopped smoking were classified as smokers by cotinine estimations.2 Self reported dietary change was similarly greater than actual change in serum lipid concentrations. The effects of this intervention are likely to be considerably less than the authors claim. The authors are not justified in concluding that their intervention is superior to other forms of health promotion that have been subjected to more rigorous evaluation.2 1. 1.↵1. Baxter T, 2. Milner P, 3. Wilson K, 4. Leaf M, 5. Nicholl J, 6. Freeman J, 7. et al . A cost effective, community based heart health promotion project in England: prospective comparative study. BMJ 1997;315:582-585. (6 September.) [OpenUrl][1][Abstract/FREE Full Text][2] 2. 2.↵1. ICRF OXCHECK Study Group . The effectiveness of health checks conducted by nurses in primary care: final results of the OXCHECK study. BMJ 1995;310:1099-1104. [OpenUrl][3][Abstract/FREE Full Text][4] # Authors' conclusions are unjustified and misleading {#article-title-5} EDITOR—Baxter et al conclude that Rotherham's heart health promotion project was so successful that “the estimated cost per life year gained was £31.”1 If this were true it would be a stunning finding and the rapid redirection of a considerable bulk of health service resources should follow. Unfortunately, the evidence for their claim is thin. The evaluation was based on a before-after comparison in two intervention communities and one control community. These communities were not well matched, … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DBaxter%26rft.auinit1%253DT.%26rft.volume%253D315%26rft.issue%253D7108%26rft.spage%253D582%26rft.epage%253D585%26rft.atitle%253DA%2Bcost%2Beffective%252C%2Bcommunity%2Bbased%2Bheart%2Bhealth%2Bpromotion%2Bproject%2Bin%2BEngland%253A%2Bprospective%2Bcomparative%2Bstudy%26rft_id%253Dinfo%253Apmid%252F9302957%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=315/7108/582&atom=%2Fbmj%2F316%2F7132%2F704.2.atom [3]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.volume%253D310%26rft.issue%253D6987%26rft.spage%253D1099%26rft.epage%253D1104%26rft.atitle%253DEffectiveness%2Bof%2Bhealth%2Bchecks%2Bconducted%2Bby%2Bnurses%2Bin%2Bprimary%2Bcare%253A%2Bfinal%2Bresults%2Bof%2Bthe%2BOXCHECK%2Bstudy%26rft_id%253Dinfo%253Apmid%252F7742676%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=310/6987/1099&atom=%2Fbmj%2F316%2F7132%2F704.2.atom