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EDITORIALS: Raphaël Bize and Jacques Cornuz Incentives to quit smoking in primary care BMJ 2008; 0: bmj.39506.386759.80v1 [Full text]

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Need to develop behavior module based on lung age

Om Prakash   (17 March 2008)

Smokers Lung

Gerald G Spence   (19 March 2008)

Need to develop behavior module based on lung age 17 March 2008
Om Prakash, Assistant Professor of Psychiatry Geriatric Clinic & Services, Department of Psychiatry, NIMHANS, Bangalore, INDIA Send response to journal: Re: Need to develop behavior module based on lung age	The editorial (1) rightly pointed out that spirometry with pictorial feedback on lung age improves quit rates. I would suggest that based on the lung age study results (2) one behavioral module could be developed for smokers. This behavioral intervention will definitely help smokers in quitting smoking by reinforcing on lung age of smokers. Nevertheless, despite not taking appropriate control group in the reported study by Parkes and colleagues (2), this study has opened a new area of research. References: 1. Raphaël Bize and Jacques Cornuz.Incentives to quit smoking in primary care. BMJ 2008; 336: 567-568. 2. Gary Parkes, Trisha Greenhalgh, Mark Griffin, and Richard Dent. Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial. BMJ 2008 336: 598-600. Competing interests: None declared
Smokers Lung 19 March 2008
Gerald G Spence, GP The Cairns Practice, Shettleston Health Centre, 420 Old Shettleston Road, Glasgow, G32 7JZ Send response to journal: Re: Smokers Lung	Any help in getting the message across to smokers about their harmful habit is to be encouraged. Interpreting spirometry readings as a lung age is very useful and can be salutary for patients who need reinforcement. Smokers however have other symptoms which may well be complained about before significant increase in lung age. Excess sputum, morning cough, shortness of breath on exercise and colds “going to the chest” are the usual complaints of our smoking patients and will often lead us to consider the diagnosis of COPD. Even before we have done spirometry we all will be fairly clear that these symptoms are due to cigarette smoking. We should stop giving patients complicating sounding names and unequivocally diagnose their symptoms as being due to “Smoker’s Lung”. Use of this term has the advantage of clearly identifying the disease with its cause and implying the potential route to improvement in their condition. By all mean use technical terms in communication between health professionals and continue to use spirometry to objectively document deteriorating lung function but the adoption of the term “Smoker’s Lung” in discussion with our patients has a lot to commend it and will reinforce the message to stop. Competing interests: None declared