Spirometry to increase smoking cessation rate: A systematic review

Elisabeth Westerdahl; Kjell Ola Engman; Mats Arne; Matz Larsson

doi:10.18332/tid/106090

Spirometry to increase smoking cessation rate: A systematic review

Tob Induc Dis. 2019 Apr 17:17:31. doi: 10.18332/tid/106090. eCollection 2019.

Authors

Elisabeth Westerdahl^{1

2}, Kjell Ola Engman³, Mats Arne^{4

5}, Matz Larsson^{6

7

8}

Affiliations

¹ Centre for Assessment of Medical Technology in Örebro, Region Örebro County, Örebro, Sweden.
² Department of Physiotherapy, University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
³ Sörmland County Council, Medical Advisory Committee, Nyköping, Sweden.
⁴ Centre for Clinical Research, Region Värmland, Karlstad, Sweden.
⁵ Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
⁶ Clinical Health Promotion Centre, Lund University, Lund, Sweden.
⁷ The Heart, Lung and Physiology Clinic, Örebro University Hospital, Örebro, Sweden.
⁸ School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Abstract

Introduction: Addressing tobacco use is an important issue in general health care. In order to improve smoking cessation advice, spirometry values can be displayed to the smoker to demonstrate possible lung function impairment. The estimate of so-called lung age may show a decrease in lung function associated with smoking. It has been suggested that performing spirometry on patients who smoke but are asymptomatic can be a useful way to show the adverse effects of smoking. The aim of this systematic review was to determine if providing spirometry results in combination with smoking cessation counselling can increase smoking cessation rates compared to what is achieved through counselling alone.

Methods: In this systematic review, we included randomized controlled trials (RCTs) evaluating smoking cessation interventions for adult smokers. The systematic search was performed in PubMed, Medline, Cochrane Library, Cinahl, Embase, Amed and PsycInfo.

Results: The literature search resulted in 946 studies, which, after reading by two independent reviewers, were reduced to seven trials that matched the inclusion criteria. Two RCTs showed significant improvement in smoking cessation when giving patients feedback on spirometry results in combination with smoking cessation counselling, compared to patients who received only smoking cessation counselling. In both studies, the spirometry results were expressed as lung age. In the other five studies no difference was found. Five further published study protocols for ongoing RCT studies in the field have been found, and therefore this systematic overview will likely need to be updated within a few years.

Conclusions: Few studies have been undertaken to examine the efficacy of spirometry in increasing smoking quit rates. Studies conducted to date have shown mixed results, and there is currently limited evidence in the literature that smoking cessation counselling that includes feedback from spirometry and a demonstration of lung age promotes quit rates.

Keywords: prevention; smoking cessation; spirometry.

Publication types

Review