Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial

doi:10.1136/bmj.39503.582396.25

BMJ 2008;336:598-600 (15 March), doi:10.1136/bmj.39503.582396.25 (published 6 March 2008)

Research

Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial

Gary Parkes, general practitioner¹, Trisha Greenhalgh, professor ², Mark Griffin, lecturer in medical statistics², Richard Dent, consultant chest physician department of chest medicine³

¹ The Limes Surgery, Hoddesdon, Hertfordshire EN11 8EP, ² Department of Primary Care and Population Sciences, University College London, London N19 5LW, ³ Queen Elizabeth II Hospital, Welwyn Garden City, Hertfordshire AL7 4HQ

Correspondence to: G Parkes Parkesko{at}hotmail.co.uk

Objective To evaluate the impact of telling patients their estimatedspirometric lung age as an incentive to quit smoking.

Design Randomised controlled trial.

Setting Five general practices in Hertfordshire, England.

Participants 561 current smokers aged over 35.

Intervention All participants were offered spirometric assessmentof lung function. Participants in intervention group receivedtheir results in terms of "lung age" (the age of the averagehealthy individual who would perform similar to them on spirometry).Those in the control group received a raw figure for forcedexpiratory volume at one second (FEV₁). Both groups were advisedto quit and offered referral to local NHS smoking cessationservices.

Main outcome measures The primary outcome measure was verifiedcessation of smoking by salivary cotinine testing 12 monthsafter recruitment. Secondary outcomes were reported changesin daily consumption of cigarettes and identification of newdiagnoses of chronic obstructive lung disease.

Results Follow-up was 89%. Independently verified quit ratesat 12 months in the intervention and control groups, respectively,were 13.6% and 6.4% (difference 7.2%, P=0.005, 95% confidenceinterval 2.2% to 12.1%; number needed to treat 14). People withworse spirometric lung age were no more likely to have quitthan those with normal lung age in either group. Cost per successfulquitter was estimated at £280 ( ${euro}$ 366, $556). A new diagnosisof obstructive lung disease was made in 17% in the interventiongroup and 14% in the control group; a total of 16% (89/561)of participants.

Conclusion Telling smokers their lung age significantly improvesthe likelihood of them quitting smoking, but the mechanism bywhich this intervention achieves its effect is unclear.

Trial registration National Research Register N0096173751.

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Rapid Responses:

Read all Rapid Responses

Usefulness of lung age: Hiroshi Kawane, et al.
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