Effect of incorporating a 10 minute point of care test for salivary nicotine metabolites into a general practice based smoking cessation programme: randomised controlled trial

Abstract

Objective To investigate the effect of immediate feedback from a point of care test for salivary nicotine metabolites in promoting smoking cessation and reduction in tobacco use. Design Prospective, operator blinded, randomised controlled trial. Setting General dental practice, London. Participants 100 adult smokers. Interventions Participants completed a questionnaire on smoking, undertook a clinical examination, and received counselling in smoking cessation. Saliva samples were analysed at presentation and at eight weeks for salivary nicotine metabolites using a 10 minute semiquantitative point of care test. Main outcome measures Smoking cessation measured by salivary nicotine metabolite values (scale 0-6), patient feedback on the perceived value of the test (visual analogue scale) in quitting, and reduction in tobacco use. Results A higher smoking quit rate was achieved with the point of care test (23% cases v 7% controls; P < 0.039), and overall tobacco use also decreased (68% cases v 28% controls; P < 0.001). Baseline values for salivary nicotine metabolites did not differ between the groups (cases, mean 4.1, SD 1.3 and 4.3, 1.4; P = 0.51). 87 participants reattended at eight weeks (44 cases, 43 controls). Mean nicotine metabolite values at eight weeks were 2.58 (2.0) for cases and 4.29 (1.8) for controls (P < 0.001). Conclusion Incorporation of individualised personal feedback using a point of care test for salivary nicotine metabolites into a general practice based smoking cessation programme increased quit rates by 17% at eight weeks and reduced tobacco use.

Metallic Free Carbon Nanotube Cluster Modified Screen Printed Electrodes for the Sensing of Nicotine in Artificial Saliva

“…For example, life insurance providers base premiums on a number of factors including that a smoker is more likely to make a claim on their policy; ex-smokers could see a dramatic drop in their life insurance costs. A study by Barnfather et al [1] have shown that a point of care test for measuring salivary nicotine improves smoking quit rates by 17% at eight weeks where the biofeedback improves motivation to quit. Additionally it has been reported that the quantification of nicotine intake from cotinine levels are less precise because of metabolic differences among subjects [5,6].…”

“…[1,2]. The World Health Organization has suggested that this death toll will rise to 8 million by 2030 [1].…”

“…More than 20 different alkaloids are found in tobacco, with nicotine being the most abundant [3]. The health risks of smoking are well documented with smokers having a greater chance of coronary heart disease, peripheral vascular disease, reduced healing rates, increase in the risk of oral cancer and reduced life expectancy [1]. Conversely, nicotine may possibly have therapeutic applications in disorders such as Tourettes, Parkinsons, depression and attention deficit disorder [4].…”

“…[1,2]. The World Health Organization has suggested that this death toll will rise to 8 million by 2030 [1]. It has been reported that over 4000 compounds exist in tobacco smoke with at least 50 shown to be carcinogenic [3].…”

Near patient tests for smoking cessation

“…The new study by Barnfather and colleagues cannot tell us, however, whether the new test for nicotine metabolites is any more or less effective for smoking cessation than dentists' advice. All trial participants were advised against smoking by their dentist, and all were administered the test; the only comparison was disclosure and feedback of test results versus non-disclosure 2. Determining whether or not testing is indeed any more or less effective than dentists' advice would be possible only with the inclusion of a trial arm in which patients received the advice alone (with no testing).…”