Outcomes are big news right now, across a variety of fields; medicine, education, science and policy. Consumers, foundations and government agencies that grant money demand results and results are demonstrated, we are told, in the guise of data.
It is no longer enough to say, it sure does seem like that speech, occupational or physical therapy is helping. We have to prove it.
What is an outcome?
Basically, it's how the story ends. It asks the question: what is the change or benefit in an individual or group as a result of the offered service?
The thorny problem with measuring outcomes is that while information is countable, experience is not. Outcome literature so much as admits this.
"Outcomes are not how many birds the worm feeds its young, but how well the fledgling flies" (United Way 2002). Hmmm, pardon me for asking, but just how can the first flight of a fledgling be enumerated in such a way that it can be given to a desk jockey in a state capital for an end-of-year statistical report?
Welcome to the thoughts in my head after wading through piles of full-text literature on outcome studies related to giving up tobacco, including the veddy dry reading of studies about the dreaded but effective medication I ingest daily to help me stay quit.
That's right, stay quit. I am still quit, despite the smoking spasm chronicled last week in these pages. This fledgling is still aiming to fly.
I am back on a tiny amount of the wretched little pill and am walking the line between not smoking and holding my food down.
The absolute best thing I have read thus far is this, straight from the British Journal of Medicine. But first, please take a moment to visualize John Cleese as speaker.
"These large trials show once again that most people find it difficult to stop smoking, even in the best possible conditions and even when they want to quit badly enough to volunteer for a randomised trial of a new treatment."
Yeah.
I have learned several exciting new facts in my research. Non-smokers metabolize caffeine twice as efficiently as smokers do, for example. This means that as a recent quitter, if I haven't simultaneously decreased my coffee habit, there is a good chance I am hopping around out of my mind on caffeine. Or this one: recent quitters have warped time perception. Really. Recent quitters stink at estimating time, suggesting that cravings really do feel like they last three hours.
Let's focus this week on the facts, the data, the information, the stuff you can put in a report, Harper's style, but compiled by me.
- 6: months of complete abstinence defined as smoking cessation.
- 2: IQ points lost by young children exposed to even small amounts of secondhand smoke.
- 440,000: premature U.S. deaths every year attributable to smoking.
- 132: dollars not spent by me on cigarettes since trying to quit.
- 500: dollars given to losing state Senate candidate Tom Eaton (R) by Philip Morris in 2006.
- 50: percent of increased caffeine levels in non-smokers, after ingesting the same amount of caffeine as smoking subjects.
- 450,000,000: worldwide tobacco related deaths expected in the coming 50 years.
- 8: number of seconds someone dies from a tobacco-related disease.
- 1.08: N.H. state cigarette tax per pack
- 1: place in town where I just can't seem to resist the allure.
- 10: number of days left for me to attempt to resist the allure. (N.H. statewide smoking ban goes into effect Sept. 17.)
- 0.39: Federal cigarette tax per pack.
- 273,857: children worldwide who became regular smokers in 2007.
- 100: percent of organs in human body harmed by smoking.
- 3: percent of quitters who are successful for one year.
- 22: average percent of Chantix-taking quitters who are successful for one year.
- 7: number of free downloadable quit meters on whyquit.com.
- 5: subscales on the Modified Cigarette Evaluation Questionnaire, including smoking satisfaction, psychological reward, enjoyment of respiratory tract sensations, craving relief and aversion.
- 90: seconds estimated by recently quit smokers when asked to estimate time (which was in fact 45 seconds).
- 45: seconds estimated by non-smokers when asked to estimate time (which was in fact 45 seconds).
- 38: percentage increase in ear infections in children exposed to any tobacco smoke in first three years of life.
- 60: in billions, dollars spent annually in United States on smoking-related illnesses.
- 1: U.S. biopharmaceutical company prepared to market a nicotine vaccine, currently in clinical trials
- 1: ongoing spending spasm by author as compensation for not smoking.
- 90: percent of smoking adults who took their first puff before age 18.
- 1: outcome unknown — will she really quit for good?
Suzanne Danforth, clinician-researcher that she is, can provide references for each of these claims. E-mail her at the risk of being swamped with data at suzanne.danforth@gmail.com.
