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When the weaknesses have more weaknesses than the study they critique. Here’s a few: 
1. The previous RCTs also found EC more effective, even though the devices were obsolete when the studies were published. The effect size was smaller because the devices weren’t as good.
2. The ‘highly selected group’ were smokers who want to quit. This is entirely normal for a stop smoking survey. Who else would you recruit? Non smokers or smokers who don’t want to quit?
3. The fact that most people don’t seek help is not a weakness of a study about helping people
4 It is not a weakness of a stop smoking trial to follow up for a year. studies that follow up longer are rare. We may yet see longer term data from this group.
Where did I get to? Oh yeah 5. It is not a weakness that behavioural support was provided to both arms of the study. It is a strength. That’s a gold standard service
6 it is not a weakness that asherenace to the treatment was sustained. This would generally be considered a strength, especially as it is associated with reduced relapse to smoking.
7 it is not a weakness that subjects were only CO tested at 12 months because it is not true. In line with best practice services CO testing was done a t base line, at quit day and every week for the first four weeks. In both arms, mark you so we are comparing like with like
8 it is not a weakness of an RCT that it is not a cross sectional population survey. RCTs are generally considered stronger, although in my view they are just different and both are useful. Also x-sectional surveys rarely use CO validation, and we all know how much that matters.
Still with me? Good on ya! 9 (9 right?) it is not a weakness that this study conflicts with well conducted x-sectional studies. It accords with them, especially studies in the country in question.
10. I’ve got tickets for the theatre and ‘Im Indoors will give me hell if I’m late so will one of you take over for me for a bit?
And here’s my top tip. Charles IIII at @towertheatre is thrilling but the last two shows are sold out. If you’re anywhere near North East London ever check it out. The fact that nobody gets paid (not even us barman) makes it a cheap night for good theatre.
