What should you do when reputable quit-smoking sources appear to disagree?

01

Work through two entirely fictional documents

All documents, services and conclusions in this exercise are invented. Review A asks whether adding a printed planning worksheet to the same personal counselling changes adults' self-reported smoking status during the seven days before a six-month assessment, compared with that counselling alone. It says the evidence is too uncertain to establish the worksheet's added benefit. No study result or real recommendation is being quoted.

Local service page B says ‘A planning worksheet is available at our counselling appointments’. It does not report a comparator, smoking outcome or effect estimate. A headline such as ‘Worksheet support offered’ might look at odds with A, but availability is not a claim that the worksheet independently improves quitting.

The defensible finding is narrow: these two statements do not contradict each other on the worksheet's incremental effect. It would also be wrong to turn A's uncertainty into proof of no effect or B's offer into evidence of benefit. Neither statement settles your choice of care.

02

Fill missing fields with ‘not reported’, not an assumption

The WHO development handbook structures evidence questions around population, intervention, comparator and outcome, with timing and setting also considered. For actual documents, copy those fields from the original methods or rationale, not just a search preview. ‘Support’ can describe very different components; counselling plus a worksheet is not a worksheet on its own.

Record the specific version, evidence search cutoff and jurisdiction as well. The publication date may differ from the search date. A service page need not contain a research comparison; mark its missing fields ‘not reported here’, rather than assuming it used A's comparison or covered every adult.

Keep certainty attached to the outcome and question assessed. WHO distinguishes confidence in effect estimates from recommendation development. A service's availability, an evidence-certainty label and a recommendation's strength are not interchangeable scores of truth.

[2]

03

Sometimes the disagreement survives the alignment

Now imagine a second wholly fictional pair: guideline C conditionally recommends offering that worksheet; guideline D makes no recommendation for or against it. The documents explicitly have the same adult population, worksheet plus the same counselling versus counselling alone, six-month seven-day smoking outcome, evidence cutoff, current version, service setting and jurisdiction. This is a real difference in recommendations within the exercise, not a difference you should explain away.

Find the evidence profiles and decision rationales. WHO describes documenting judgments that connect evidence to recommendations; adapted recommendations may change those judgments. Check whether C and D actually use the same included evidence and certainty assessment, and what each says about benefits, harms and other decision factors. Equal cutoff dates alone do not prove identical evidence.

If the rationales are unavailable or do not explain the difference, preserve that limit. Ask each publisher: ‘Which evidence and judgments explain this recommendation, and how does it differ from the other document?’ Do not invent a cost, cultural or commercial explanation, average the recommendations, or treat silence as a recommendation against the worksheet.

[1][2]

04

Leave a useful comparison, not a personal prescription

A practical note for the first pair is: ‘A assesses uncertain added benefit; B confirms only a service offer; the effect claim is not contradicted.’ For the second: ‘The recommendation difference remains unexplained; the rationales and evidence profiles are needed.’ This is a more useful result than choosing the newer logo or the strongest wording.

NHS information provides UK cessation-service routes. For questions about your own care, use a qualified professional and confirm relevant service availability and conditions. You may bring the two public documents and your precise unresolved question; this page does not collect your history, symptoms or medicines. Send any necessary personal facts only through the service's own privacy procedures.

[3]

05

What to keep in mind

• Match the exact question before calling statements contradictory.
• Uncertain added benefit and service availability can coexist.
• An unexplained recommendation difference remains unresolved, not a personal-care instruction.