Explaining 'Lung Age' Motivates Smokers to Quit

By Bell, John R. | Clinical Psychiatry News, May 2008 | Go to article overview

Explaining 'Lung Age' Motivates Smokers to Quit


Bell, John R., Clinical Psychiatry News


Smokers who were told their "lung age" after spirometry had more than double the rate of quitting 12 months later than did smokers who were given only a clinical measure of lung performance, according to findings of a randomized controlled trial.

Thus, telling smokers their lung age appears to be as effective as nicotine replacement, counseling, and bupropion--as well as cheaper, the authors noted in their study.

Dr. Gary Parkes of the Limes Surgery, Hoddesdon, England, and colleagues enrolled 561 current smokers from five primary care practices in one English county. Patients were at least 35 years old (mean age, 53 years) and did not have a history of lung disease or use supplemental oxygen.

All of the patients were given a series of spirometric tests, advised during the visit to quit smoking, and offered referral to a support service.

Each patient was then randomized to receive one of two types of information: Those patients in the intervention group received an individualized explanation of their level of forced expiratory volume in 1 second (FEV.sub.1), along with a verbal explanation of their lung age and a graphic explaining the concept of lung age. Lung age was calculated using a previously established formula. (See box)

Lung-Age Calculations

* For men: Lung age = (2.87 x height [in inches]) - (31.25 x observed FE[V.sub.1] [in liters]) 39.375

* For women: Lung age = (3.56 X height [in inches]) - (40 x observed FE[V.sub.1] [in liters])-77.28

Those patients in the control group received only a letter indicating their [FEV.sub.1] score, with no further explanation.

In each group, the average number of cigarettes smoked daily was 17. The mean number of pack-years was 30 in the control group (281 persons) and 31 in the intervention group (280 persons).

At 12 months, there were 249 control participants, 32 having been lost to follow-up. In the intervention group, there were also 249 patients remaining, with 31 lost to follow-up. However, those lost to follow-up were included as if they had continued to smoke.

Among the controls, there were 18 patients (6%) who quit smoking, as verified by carbon-monoxide breath testing.

In the intervention group, there were 38 patients who quit (14%).

The investigators analyzed the data among the intervention group to determine if those with a greater lung-age deficit were more likely to quit than those with a smaller deficit or none. Contrary to previously published findings, they found no significant difference in quit rates based on disclosed lung damage, although they cautioned that the study was not powered to detect such a difference.

Anecdotally, they noted, some patients who were informed that their lung age was normal expressed relief that it was not too late for them to quit (BMJ 2008 March 6 [Epub doi:10. …

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