New Smoking Cessation Research Presented At CHEST 2009

Main Category: Smoking / Quit Smoking
Also Included In: Clinical Trials / Drug Trials;  Primary Care / General Practice;  COPD
Article Date: 05 Nov 2009 - 4:00 PDT

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New Formula Calculates More Accurate 'Lung Age' in Smokers
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A new formula more accurately calculates a smoker's "lung age," which researchers hope will help persuade patients to quit the habit. A research team from Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA, developed and evaluated a new lung age formula based on %FEV1/FEV6 rather than the current lung age formulas based on height and FEV1 or FVC. They found that the new formula closely approximated actual lung ages in 5,800 never-smokers, while values using the earlier formulas were erratic. They also found that in 3,500 current smokers, mean increases in lung age progressed to more than 25 years by age 50 and above, much higher but less erratic than using lung ages based on earlier formulas. Researchers conclude that sharing physiological lung age with smokers may be more effective in smoking cessation than sharing spirometry results.

Pulmonary Rehab May Improve Smoking Cessation Rates
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New research shows that patients who smoke who participate in a structured pulmonary rehabilitation (PR) program achieve higher abstinence rates than those who receive usual care. A research team from Montreal compared smoking cessation rates among 413 patients with chronic obstructive lung disease (COPD). Of the patients, 27 subjects participated in a PR program, while 386 received standard care. After a follow-up of 31±24 months, 81.5 percent of patients in the PR group had at least a short-term abstinence compared with only 46.1 percent in the non-PR group. Additionally, 37 percent of patients in the PR group showed signs of sustained quitting, compared with 8 percent in the non-PR group. Researchers conclude that PR may play a role in smoking cessation in patients with COPD.

Clinicians Lack Training in Smoking Cessation
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Physicians, nurses, and other health-care providers receive limited training on smoking cessation strategies. University of Arizona researchers surveyed 250 hospital employees about the extent of their smoking cessation training and knowledge of smoking cessation methods. Results showed that more than 50 percent of nonphysician patient care providers talk at least weekly with their patients about smoking and smoking cessation. However, only 24 percent of nurses and 15 percent of medical technicians have formal training on the subject, and both groups had limited knowledge of smoking cessation strategies. Furthermore, less than half of the physicians surveyed reported having any formal training in techniques of smoking cessation, and only 54 percent were aware of patient support resources such as telephone help/quit lines. Researchers suggest that significant education of health-care providers at all levels is needed to allow them to effectively help their patients understand the risks of smoking and methods of smoking cessation.

Varenicline Effective and Well Tolerated for Smoking Cessation
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New research shows that varenicline is an effective therapy for smoking cessation and is well tolerated among patients with chronic obstructive lung disease (COPD). In a 27-center, double-blind, multinational study, researchers from the University of California, Los Angeles and UBC Scientific Solutions in the United Kingdom assessed the efficacy and safety of varenicline in patients with mild to moderate COPD. Patients were randomized to receive either varenicline (n=248) or placebo (n=251) for 12 weeks, with a 40-week nontreatment follow-up. At weeks 9 and 12, the continuous abstinence rate (CAR) was significantly higher for varenicline (42.3 percent) vs placebo (8.8 percent). Greater varenicline efficacy also was maintained during weeks 9 and 52 (varenicline CAR, 18.6 percent vs placebo CAR, 5.6 percent). Serious events adverse occurred in 2.8 percent of patients receiving varenicline and 4.4 percent of patients receiving placebo. Two patients receiving varenicline died during the study, as did one patient receiving placebo. One suicidal ideation event was reported for placebo; no such event was reported for varenicline. Reports of depression, depressed mood, and depressive symptoms were similar for both treatment groups.

Source: Jennifer Stawarz
American College of Chest Physicians

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