Veracity of Smokers' Response Regarding Abstinence at Smoking Cessation Clinics

Barrueco, M.; Ruiz, Carlos Jiménez; Palomo, Luis; Torrecilla, M.; Romero, P.; Riesco, Juan Antonio

doi:10.1016/s1579-2129(06)60414-x

Cited by 16 publications

(14 citation statements)

References 21 publications

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“…We consider self-reported point abstinence rates more realistic and similar to those obtained in previous studies. Although continuous abstinence is considered the gold standard outcome for smoking cessation [29], some studies have shown that smokers do not lie about their smoking status when asked about it directly [30]. …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of intensive group and individual interventions for smoking cessation in primary health care settings: a randomized trial

Ramos¹,

Ripoll²,

Estrades³

et al. 2010

BMC Public Health

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ObjectivesPrimary: To compare the effectiveness of intensive group and individual interventions for smoking cessation in a primary health care setting; secondary: to identify the variables associated with smoking cessation.MethodsThree-pronged clinical trial with randomisation at the individual level. We performed the following: an intensive individual intervention (III), an intensive group intervention (IGI) and a minimal intervention (MI). Included in the study were smokers who were prepared to quit smoking. Excluded from the study were individuals aged less than 18 years or with severe mental conditions or terminal illnesses. The outcome measure was continued abstinence at 12 months confirmed through CO-oximetry (CO). The analysis was based on intention to treat.ResultsIn total, 287 smokers were recruited: 81 in the III, 111 in the IGI, and 95 in the MI. Continued abstinence at 12 months confirmed through CO was 7.4% in the III, 5.4% in the IGI, and 1% in the MI. No significant differences were noted between III and MI on the one hand, and between IGI and MI on the other [RR 7.04 (0.9-7.2) and RR 5.1 (0.6-41.9), respectively]. No differences were noted between IGI and III [RR 0.7 (0.2-2.2)]. In multivariate analysis, only overall visit length showed a statistically significant association with smoking cessation.ConclusionsThe effectiveness of intensive smoking interventions in this study was lower than expected. No statistically significant differences were found between the results of individual and group interventions.Trial registration numberISRCTN32323770

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Section: Discussionmentioning

confidence: 99%

Effectiveness of intensive group and individual interventions for smoking cessation in primary health care settings: a randomized trial

Ramos¹,

Ripoll²,

Estrades³

et al. 2010

BMC Public Health

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“…(8) Among the biochemical markers that are most widely used in order to verify smoking status are exhaled carbon monoxide (COex) levels and the determination of cotinine levels in serum, urine or saliva, salivary cotinine level being considered the gold standard due to its specificity and sensitivity. (9) Since the determination of COex levels is noninvasive, is inexpensive and yields immediate results, it is the method that has been the most widely used in research and in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Avaliação da concentração de monóxido de carbono no ar exalado em tabagistas com DPOC

Chatkin

Aued

et al. 2010

J. bras. pneumol.

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OBJETIVO: Medir os níveis de monóxido de carbono no ar exalado (COex) em tabagistas com e sem DPOC. MÉTODOS: Tabagistas frequentadores dos ambulatórios do Hospital São Lucas em Porto Alegre (RS) entre setembro de 2007 e março de 2009 foram convidados a participar do estudo. Os participantes responderam a um questionário com características demográficas e epidemiológicas e realizaram espirometria, medição de cotinina urinária e de COex. Os participantes foram agrupados conforme a presença de DPOC. RESULTADOS: Foram incluídos 294 tabagistas, 174 (59,18%) diagnosticados com DPOC. Todos os participantes apresentavam níveis de cotinina urinária > 50 ng/mL. Os fumantes com DPOC apresentaram medianas significativamente superiores as do grupo sem DPOC para as variáveis idade e maços-ano (p < 0,001 e p = 0,026, respectivamente). Não houve diferença significativa nas demais variáveis. Quando ajustados para sexo, início do tabagismo, cigarros/dia e cotinina urinária, os valores médios de COex foram mais altos no grupo DPOC que no grupo sem DPOC, mas sem significância estatística (17,8 ± 0,6 ppm e 16,6 ± 0,7 ppm, respectivamente; p = 0,200). As diferenças permaneceram não significativas quando o método de base logarítmica foi usado. Uma ampla dispersão dos valores de COex foi encontrada quando os participantes foram classificados conforme os valores de VEF1 (r = -0,06; p = 0,53) ou o sistema de classificação de Global Initiative for Chronic Obstructive Lung Disease (r = 0,08; p = 0,34). As proporções de resultados falso-negativos para tabagismo foram de 18,4% e 6,7%, respectivamente, nos grupos com e sem DPOC (p = 0,007). CONCLUÕES: Esse estudo mostrou que os valores de COex não apresentaram diferenças significativas em fumantes com ou sem DPOC. Desse modo, parece não haver nenhuma restrição relevante para a sua aplicabilidade em fumantes com DPOC.

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“…This is in accordance with the literature. 9 We also studied CO Exh testing as a marker of abstinence, calculating the likelihood ratio for each different level. Using this statistical procedure, we were able to calculate the accuracy of each cut-off point and evaluate how many times more (or less) it predicted the real smoking condition.…”

Section: Discussionmentioning

confidence: 99%

“…Lower incidences of unreliable reporting are found in general population surveys while higher proportions are found in patients enrolled in quitsmoking programs. [9][10][11] To avoid these biases, biochemical markers for abstinence have been introduced in clinical practice. Carbon monoxide level in exhaled air (CO Exh ) is the most often used.…”

Section: Introductionmentioning

confidence: 99%

Exhaled carbon monoxide as a marker for evaluating smoking abstinence in a Brazilian population sample

Chatkin

Fritscher

Abreu

et al. 2007

Primary Care Respiratory Journal

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Background: Exhaled carbon monoxide (CO Exh ) measurement is used to confirm smoking status in smoking cessation programs, but the cut-off level is still a matter for discussion. The objective of this study was to compare CO Exh levels in smokers and non-smokers to validate the method in a Brazilian population and to estimate the probability of the patient still smoking according to different cut-off points. Methods: In this cross-sectional study we studied non-atopic Caucasian volunteers with no respiratory infection or steroid therapy in the preceding four weeks. Exclusion criteria were: pregnancy; breast feeding; age<18 and >65 years old; and subjects not signing informed consent. Participants filled out a questionnaire and had their CO Exh levels measured. Bayes' theorem was used to calculate the posttest probabilities. Results: We included 393 subjects of whom 239 (61%) were smokers. The mean CO Exh was 14.7 +/-9.4ppm and 4.3 +/-2.5ppm (p<0.001) in smokers and nonsmokers, respectively. Patients with CO Exh below 8ppm had a likelihood ratio below 1 of still smoking. The levels 9ppm and 10ppm provided likelihood ratios of 1.50 and 1.93, respectively. Better discriminant power was obtained at >11ppm, when the likelihood ratio became 63.80 (95%CI 16.1-253.1). Conclusions: In smoking cessation practice, a likelihood ratio approach may be useful to determine the probability that an individual is still smoking according to various CO Exh cut-off points instead of using a fixed value for all patients.

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Veracity of Smokers' Response Regarding Abstinence at Smoking Cessation Clinics

Cited by 16 publications

References 21 publications

Effectiveness of intensive group and individual interventions for smoking cessation in primary health care settings: a randomized trial

Effectiveness of intensive group and individual interventions for smoking cessation in primary health care settings: a randomized trial

Avaliação da concentração de monóxido de carbono no ar exalado em tabagistas com DPOC

Exhaled carbon monoxide as a marker for evaluating smoking abstinence in a Brazilian population sample

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