Ellie Grossman, MD, MPH; Scott Sherman, MD, MPH
Does describing to patients how smoking has accelerated their age-related decline in lung function (“lung age”) increase smoking cessation rates?
Randomized controlled trial.
Blinded (outcome assessors).*
5 general practices in Hertfordshire, England, United Kingdom.
561 current smokers ≥ 35 years of age (mean age 53 y, 54% women, mean 17 cigarettes/d, mean 33 pack-y of smoking). Patients who were receiving oxygen or had a history of lung cancer, tuberculosis, asbestosis, silicosis, bronchiectasis, or pneumonectomy were excluded.
All patients had spirometry at baseline to measure FEV1. Patients in the intervention group (n = 280) were immediately given their results verbally and graphically as “lung age” (age of the average healthy person who has an FEV1 equal to that of the patient); patients in the control group (n = 281) were not told their results at that time. Within 4 weeks, all patients received a letter from the study doctor, giving test results (as lung age for the intervention group and as FEV1 [L/s] with no explanation for the control group), a strong statement about the importance of smoking cessation regardless of the test results, and contact details for smoking cessation services.
Smoking cessation (verified by saliva cotinine test) and daily cigarette consumption.
89% (intention-to-treat analysis).
At baseline, 27% of the intervention group and 23% of the control group had abnormal FEV1 (<80% of predicted). In the intervention group, mean lung age deficit (lung age minus actual age) was 9.3 years. Telling patients their lung age increased verified smoking cessation rate and reduced daily cigarette consumption (Table).
Telling smokers their lung age after spirometry increased the likelihood of successful smoking cessation a year later.
Reporting spirometry results as “lung age” vs simple FEV1 to promote smoking cessation†
†Abbreviations defined in Glossary. RBI, NNT, and CI calculated from data in article.
Grossman E, Sherman S. Telling smokers their “lung age” promoted successful smoking cessation. Ann Intern Med. 2008;149:JC1–5. doi: 10.7326/0003-4819-149-2-200807150-02005
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Published: Ann Intern Med. 2008;149(2):JC1-5.
Cardiology, Coronary Risk Factors, Pulmonary/Critical Care, Smoking, Tobacco, Alcohol, and Other Substance Abuse.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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