Smoking cessation and development of respiratory health in smokers screened with normal spirometry

Self-Reported Smoking Status 10-Months After a Single Session Intervention Including an Education Conference About Smoking Harms and Announcement of Spirometric Lung-Age

Background

Studies investigating the effects of announcing spirometric lung-age (SLA) on the smokers' self-reported smoking status reported conflicting results.

Main objective

To evaluate the effects of a single session intervention including an education conference about smoking harms and announcement of SLA on the participants' self-reported smoking status.

Methodology

An interventional study was conducted in a cable factory. The intervention included four steps: PowerPoint presentation about raising smoking hazards awareness; general questionnaire; measurement of the anthropometric and spirometric data, and announcement of SLA; and evaluation of the smokers' self-reported smoking status 10 months later (quitted smoking, decreased consumption; stable consumption, increased consumption).

Results

Thirty-six smokers completed the four steps. Ten months after the intervention, 11.1% of smokers quitted smoking, 52.7% decreased their consumption by 7  ±  4 cigarettes/day, 30.5% kept a stable consumption, and 5.5% increased their consumption by 9  ±  6 cigarettes/day.

Conclusion

Providing an education conference combined with announcing SLA motivated 64% of smokers to quit smoking or to reduce their cigarette consumption.

A pilot randomized controlled trial on the effectiveness of a 'lung age' intervention on smoking cessation: study protocol

AIM

To evaluate the effectiveness of the 'lung age' intervention on smoking cessation rates, smoking abstinence self-efficacy, nicotine dependence and behavioural change among the smoking population in Singapore.

BACKGROUND

Tobacco use has been linked to several preventable chronic diseases, such as cardiovascular diseases, stroke, cancers and respiratory diseases. Despite numerous health education attempts to promote smoking cessation, there has been a sustained increase in smoking rates worldwide, including in Singapore.

DESIGN

A pilot randomized controlled trial.

METHODS

A convenience sample of 108 smoking individuals will be recruited from population health screenings conducted by a tertiary public hospital in Singapore, with 54 participants in the experimental group and 54 in the control group. Participants in the experimental group will receive a lung age intervention, consisting of lung age determination and education as well as smoking cessation advice, while the researchers will provide those in the control group with the usual smoking education. Outcome measures include smoking cessation rates, smoking abstinence self-efficacy, nicotine dependence and assessment of the stages of behavioural change. Data will be collected at the baseline and again at the 3- and 6-month follow-ups.

DISCUSSION

This study offers an additional intervention to improve smoking cessation rates in Singapore. It aims to reduce or delay the onset of smoking-related chronic diseases such as coronary heart diseases and cancer, which would eventually reduce the healthcare burden in an increasingly ageing society.

TRIAL REGISTRATION NUMBER

ISRCTN15839687.

Does the duration of smoking cessation have an impact on hospital admission and health-related quality of life amongst COPD patients?

BACKGROUND

Lack of awareness among ex-smokers on the benefits of sustaining smoking cessation may be the main cause of their smoking relapse. This study explored health-related quality of life (HRQoL) and hospital admission amongst chronic obstructive pulmonary disease (COPD) patients according to the duration of smoking cessation.

MATERIALS AND METHODS

This study recruited COPD patients from a chest clinic who agreed to participate in a medication therapy-adherence program from January to June 2013. They were interviewed during their visits to obtain information regarding their smoking history and HRQoL. They were divided into three groups according to smoking status (sustained quitters, quit ≥5 years; quitters, quit <5 years; and smokers, smoking at least one cigarette/day). The effects of the duration of cessation on HRQoL and hospital admission were analyzed using a multinomial logistic model.

RESULTS

A total of 117 participants with moderate COPD met the inclusion criteria, who were comprised of 41 sustained quitters, 40 quitters, and 36 smokers. Several features were similar across the groups. Most of them were married elderly men (aged >64 years) with low-to-middle level of education, who smoked more than 33 cigarettes per day and had high levels of adherence to the medication regimen. The results showed that sustained quitters were less likely to have respiratory symptoms (cough, phlegm and dyspnea) than smokers (odds ratio 0.02, confidence interval 0-0.12; P<0.001). The hospital admission rate per year was increased in quitters compared to smokers (odds ratio 4.5, confidence interval 1.91-10.59; P<0.005).

CONCLUSION

A longer duration of quitting smoking will increase the benefits to COPD patients, even if they experience increased episodic respiratory symptoms in the early period of the cessation. Thus, the findings of this study show the benefits of early smoking cessation.

Cigarette and waterpipe smoking decrease respiratory quality of life in adults: results from a national cross-sectional study

Background. Chronic obstructive pulmonary disease (COPD) is gaining an importance over the world, and its effect on quality of life is better grasped. Our objective was to use the Clinical COPD Questionnaire (CCQ) to describe the respiratory quality of life in the Lebanese population, stressing on differences between smokers and nonsmokers. Methods. Using data from a cross-sectional national study, we checked the construct validity and reliability of the CCQ. Factors and items correlation with postbronchodilator FEV1/FVC were reported, in addition to factors and scale association with COPD and its severity. We then conducted a multiple regression to find predictors of quality of life. Results. The CCQ demonstrated excellent psychometric properties, with adequacy to the sample and high consistency. Smokers had a decreased respiratory quality of life versus nonsmokers, independently of their respiratory disease status and severity. This finding was confirmed in COPD individuals, where several environmental factors, lower education, and cumulative smoking of cigarette and of waterpipe were found to be independent predictors of a lower quality of life, after adjusting for COPD severity. Conclusions. Smoking decreases the respiratory quality of life of Lebanese adults; this issue has to be further emphasized during smoking cessation and patients' education.

Issues in pulmonary function testing for the screening and diagnosis of chronic obstructive pulmonary disease

PURPOSE OF REVIEW

The purpose of this review article is to provide an up-to-date summary on the current evidence for or against the use of lung function tests as screening and diagnostic tools for airflow obstruction in chronic obstructive pulmonary disease (COPD), and to consider the relevant issues in context.

RECENT FINDINGS

COPD is characterized by chronic respiratory symptoms and airflow limitation with only partial reversibility on lung function testing. However, screening on a population basis or of an enriched 'at-risk' subset like chronic smokers is not supported by findings from previous epidemiological studies, screening trials or in currently published clinical management guidelines by professional societies and review bodies. The definition of airflow obstruction and the classification of disease severity of COPD also differ slightly between guidelines and statements from different professional societies.

SUMMARY

Given the experience from previous screening trials and controversial classification of airflow obstruction by severity, it is impossible to have accurate screening results for COPD based on lung function tests alone. Clinical respiratory symptoms should be taken into consideration in terms of the diagnosis and management of COPD, as well as in any screening trial or programme that is to be attempted or implemented.

Motivating smokers in the hospital pulmonary function laboratory to quit smoking by use of the lung age concept

INTRODUCTION

The purpose of this study was to investigate the use of lung age to motivate a quit attempt among smokers presenting to a hospital pulmonary function testing (PFT) laboratory.

METHODS

Participants were randomized to receive a lung age-based motivational strategy (intervention group) versus standard care (control group). At 1 month, all participants were interviewed by telephone to determine whether they made a quit attempt.

RESULTS

A total of 67 participants were enrolled, and 51 completed the study. Baseline mean data included age = 52 years, 70% women, 40 pack-years of smoking, FEV(1) = 69% predicted, and lung age = 83 years. The quit attempt rates were not different between the intervention and control groups (32% vs. 24%, respectively, p = .59). There was a near significant interaction between lung age and intervention strategy (p = .089), with quit attempt rates among those with normal lung age of 18% in the intervention group versus 33% in the control group and among those with high (worse) lung age of 39% in the intervention group versus 17% in the control group; p = .38.

CONCLUSIONS

Using lung age to motivate smokers presenting to the PFT laboratory to quit may succeed in patients with high lung age but may undermine motivation in smokers with normal lung age. Further work is needed to refine the approach to smokers with normal lung age.