HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: 33/4/754    most recent 09031936.00116308v1 Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kotz, D. Articles by van Schayck, O. C. P. Search for Related Content PubMed PubMed Citation Articles by Kotz, D. Articles by van Schayck, O. C. P.

Efficacy of confronting smokers with airflow limitation for smoking cessation

¹ Dept of General Practice, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre, ² Dept of Respiratory Medicine, Maastricht University Medical Centre, and ³ Dept of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.

CORRESPONDENCE: D. Kotz, Dept of General Practice, School for Public Health and Care (CAPHRI), Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Fax: 31 433619344. E-mail: d.kotz{at}hag.unimaas.nl

Keywords: Chronic obstructive pulmonary disease, confrontational counselling, respiratory nurse, smoking cessation, spirometry

Received: November 30, 2008
Accepted December 5, 2008

The objective of the present study was to test whether confronting smokers with previously undetected chronic obstructive pulmonary disease (COPD) increases the rate of smoking cessation.

In total, 296 smokers with no prior diagnosis of COPD were detected with mild-to-moderate airflow limitation by means of spirometry and randomly allocated to: confrontational counselling by a nurse with nortriptyline for smoking cessation (experimental group); regular counselling by a nurse with nortriptyline (control group 1); or "care as usual" for smoking cessation by the general practitioner (control group 2). Only the experimental group was confronted with their abnormal spirometry (mean forced expiratory volume in one second (FEV₁) post-bronchodilator 80.5% predicted, mean FEV₁/forced vital capacity post-bronchodilator 62.5%).

There was no difference in cotinine-validated prolonged abstinence rate between the experimental group (11.2%) and control group 1 (11.6%) from week 5–52 (odds ratio (OR) 0.96, 95% confidence interval (CI) 0.43–2.18). The abstinence rate was approximately twice as high in the experimental group compared with control group 2 (5.9%), but this difference was not statistically significant (OR 2.02, 95% CI 0.63–6.46).

The present study did not provide evidence that the confrontational approach increases the rate of long-term abstinence from smoking compared with an equally intensive treatment in which smokers were not confronted with spirometry. The high failure rates (88%) highlight the need for treating tobacco addiction as a chronic relapsing disorder.

This article has been cited by other articles:

				B.-M. Sundblad, K. Larsson, and L. Nathell Lung function testing influences the attitude toward smoking cessation Nicotine Tob Res, November 19, 2009; (2009) ntp170v1. [Abstract] [Full Text] [PDF]

				D Kotz, R Vos, and M J H Huibers Ethical analysis of the justifiability of labelling with COPD for smoking cessation J. Med. Ethics, September 1, 2009; 35(9): 534 - 540. [Abstract] [Full Text] [PDF]

				J. B. Soriano and G. Parkes Remember elephants and icebergs... "Your lung function should be here, but it is there!" Eur. Respir. J., April 1, 2009; 33(4): 715 - 716. [Full Text] [PDF]