Authors (including presenting author) :
Chui WWY, Chen XR, Hung LL
Affiliation :
Department Family Medicine & General Outpatient Clinic, Kowloon Central Cluster
Introduction :
Targeting smokers without intention to quit become quite a challenge as they are least likely to seek professional help from smoking cessation services. One of the possible useful tools is to use spirometry feedback as part of the individualized behavioral counselling. Local data on the effectiveness of using hand-held spirometer as a motivational tool for smoking cessation is still lacking.
Objectives :
To assess whether providing smokers with lung age information using a hand-held spirometer (COPD-6) during smoking cessation counselling (SCC) will increase quit attempts compared to standard care when pharmacotherapy is not used.
Methodology :
An open-label, randomized control trial in public primary care clinics
Subjects: Active smokers fulfilling the inclusion criteria were recruited during their visit to the General Outpatient Clinics of Kowloon Central Cluster from 15/10/2018 to 30/01/2019. They were randomized to either the intervention group (SCC and lung function test using COPD-6) or control group (SCC only). Primary outcomes are 1) self-reported 7-day point prevalent abstinence (PPA) at Week 1, Month 1, and Month 3; and 2) sustained abstinence at Month 6. Secondary outcomes are reduction in cigarettes smoked for those who have not quit, and progression in stage of change.
Result & Outcome :
A total of 147 participants was included in the study with 11% lost to follow up. The mean age of all participants was 61.5±12.3 years and more than 80% were male. The average number of cigarettes smoked was 12.5±6.7 and at least 40% of them had tried quitting before. Self-reported 7-day PPA was significantly higher in the intervention group for all study time points (all < 0.05). The intervention arm had a significantly greater number of smokers with absolute abstinence by Month 6 (p=0.005). For those who did not quit, the reduction in the number of cigarettes smoked was comparable in the two groups (p=0.3). The rate of forward progression in the stage of change was much greater in the intervention arm.
COPD-6 could be effectively used as motivational tool for smoking cessation. Incorporating the lung age information during the SCC significantly improved the quit rate up to six months. In addition, smokers who received the biofeedback intervention had greater forward progression on the Wheel of Stage during smoking cessation despite their readiness to quit.
