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

doi:10.1136/bmj.38621.463900.7C

BMJ 2005;331:999 (29 October), doi:10.1136/bmj.38621.463900.7C (published 6 October 2005)

Primary care

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

Kristian D Barnfather, general dental surgeon¹, Graham F Cope, research fellow², Iain L Chapple, professor of periodontology³

¹ General Practice, 6 Harcourt House, London W1G 0PN, ² Wolfson Applied Technology Laboratory, Queen Elizabeth Medical Centre, Edgbaston, Birmingham B15 2TH, ³ Periodontal Research Group, University of Birmingham, St Chad's Queensway, Birmingham B4 6NN

Correspondence to: I L Chapple I.L.C.Chapple{at}bham.ac.uk

Objective To investigate the effect of immediate feedback froma point of care test for salivary nicotine metabolites in promotingsmoking cessation and reduction in tobacco use.

Design Prospective, operator blinded, randomised controlledtrial.

Setting General dental practice, London.

Participants 100 adult smokers.

Interventions Participants completed a questionnaire on smoking,undertook a clinical examination, and received counselling insmoking cessation. Saliva samples were analysed at presentationand at eight weeks for salivary nicotine metabolites using a10 minute semiquantitative point of care test.

Main outcome measures Smoking cessation measured by salivarynicotine metabolite values (scale 0-6), patient feedback onthe 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 pointof care test (23% cases v 7% controls; P < 0.039), and overalltobacco use also decreased (68% cases v 28% controls; P <0.001). Baseline values for salivary nicotine metabolites didnot 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 (44cases, 43 controls). Mean nicotine metabolite values at eightweeks were 2.58 (2.0) for cases and 4.29 (1.8) for controls(P < 0.001).

Conclusion Incorporation of individualised personal feedbackusing a point of care test for salivary nicotine metabolitesinto a general practice based smoking cessation programme increasedquit rates by 17% at eight weeks and reduced tobacco use.

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Don�t give up the CO monitor just yet: John A Stapleton
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Re: Don�t give up the CO monitor just yet: Iain L C Chapple, et al.
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