4.6 Article

Effectiveness of a motivational intervention based on spirometry results to achieve smoking cessation in primary healthcare patients: randomised, parallel, controlled multicentre study

Journal

JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH
Volume 75, Issue 10, Pages 1001-1009

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/jech-2020-216219

Keywords

smoking; public health; epidemiology

Funding

  1. University Institute for Research in Primary Care - IDIAP Jordi Gol (Barcelona, Spain)

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Providing detailed spirometry information to participants with normal lung function doubled prolonged smoking cessation rates compared to only providing brief smoking cessation advice. This intervention was found to be more effective in achieving smoking cessation in primary healthcare during the 12-month follow-up period.
Objective This 12-month study in a primary healthcare network aimed to assess the effectiveness of usual smoking cessation advice compared with personalised information about the spirometry results. Design Randomised, parallel, controlled, multicentre clinical trial. Setting This study involved 12 primary healthcare centres (Tarragona, Spain). Participants Active smokers aged 35-70 years, without known respiratory disease. Each participant received brief smoking cessation advice along with a spirometry assessment. Participants with normal results were randomised to the intervention group (IG), including detailed spirometry information at baseline and 6-month follow-up or control group (CG), which was simply informed that their spirometry values were within normal parameters. Main outcome Prolonged abstinence (12 months) validated by expired-CO testing. Results Spirometry was normal in 571 patients in 571 patients (45.9% male), 286 allocated to IG and 285 to CG. Baseline characteristics were comparable between the groups. Mean age was 49.8 (SD +/- 7.78) years and mean cumulative smoking exposure was 29.2 (+/- 18.7) pack-years. Prolonged abstinence was 5.6% (16/286) in the IG, compared with 2.1% (6/285) in the CG (p=0.03); the cumulative abstinence curve was favourable in the IG (HR 1.98; 95% CI 1.29 to 3.04). Conclusions In active smokers without known respiratory disease, brief advice plus detailed spirometry information doubled prolonged abstinence rates, compared with brief advice alone, in 12-month follow-up, suggesting a more effective intervention to achieve smoking cessation in primary healthcare.

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