Skip to main content
Top
Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Study protocol

Multicentric randomized clinical trial to evaluate the long-term effectiveness of a motivational intervention against smoking, based on the information obtained from spirometry in primary care: the RESET study protocol

Authors: Francisco Martin-Lujan, Antoni Santigosa-Ayala, Josep-Lluis Piñol-Moreso, Mar Sorli-Aguilar, Gemma Flores-Mateo, Jordi Bladé-Creixenti, Josep Basora-Gallisà, Rosa Sola-Alberich, for the RESET Study Group investigators

Published in: BMC Primary Care | Issue 1/2016

Login to get access

Abstract

Background

Spirometry is the recommended method of evaluating pulmonary function when respiratory disease is suspected in smokers. Nonetheless, no evidence exists of the usefulness of information obtained from this test as a motivational strategy for smoking cessation. The primary objective of this study is to evaluate the effectiveness of a motivational intervention based on spirometry results in achieving long-term smoking cessation.

Methods/Design

We propose a multicenter randomized clinical trial in the primary care setting. Study subjects: We will recruit active smokers of both sexes, aged 35-70 years, with a cumulated smoking habit exceeding 10 packs/year and who consult for any reason with their primary care physician in the 20 health centers in the province of Tarragona (Spain). Patients with a history of lung disease or who have undergone exploratory measures of pulmonary function in the preceding 12 months will be excluded. All patients who agree to participate will provide signed informed consent prior to their inclusion. A total of 1000 smokers will be consecutively randomized to a control or intervention group (1:1). Intervention: Participants in both groups will receive brief (5-minute) health counseling, in accordance with usual clinical practice. In a consultation lasting about 15 minutes, participants in the intervention group will also receive detailed, personalized information about the results of a spirometry test and about their lung age compared with their chronological age. Both groups will be followed up for 12 months. Main variables and analysis: The main variable will be sustained smoking abstinence at 12 months after the intervention, as confirmed by CO breath testing and urine cotinine test. Results will be analyzed based on intention to treat, using the chi-square test and logistical regression if necessary to adjust for confounding variables.

Discussion

We expect the rate of prolonged smoking abstinence in the intervention group will be at least 5 % higher than in the control group. If this strategy proves effective, it could easily be included in the health promotion activities offered in primary care settings.

Trial registration

ClinicalTrials.gov Identifier: NCT02153047. Registered on 28/05/2014
Literature
1.
go back to reference Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. A clinical practice guideline for treating tobacco use and dependence: 2008 update. A U.S. Public Health Service report. Am J Prev Med. 2008;35:158–76.CrossRef Fiore MC, Jaén CR, Baker TB, Bailey WC, Benowitz NL, Curry SJ, et al. A clinical practice guideline for treating tobacco use and dependence: 2008 update. A U.S. Public Health Service report. Am J Prev Med. 2008;35:158–76.CrossRef
2.
go back to reference Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004;328:1519–33.PubMedCentralCrossRefPubMed Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004;328:1519–33.PubMedCentralCrossRefPubMed
7.
go back to reference Whitlock EP, Orleans CT, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med. 2002;22:267–84.CrossRefPubMed Whitlock EP, Orleans CT, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: an evidence-based approach. Am J Prev Med. 2002;22:267–84.CrossRefPubMed
8.
go back to reference Hughes JR, Keely J, Naud S. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004;99:29–38.CrossRefPubMed Hughes JR, Keely J, Naud S. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction. 2004;99:29–38.CrossRefPubMed
9.
go back to reference Young RP, Hopkins RJ, Smith M, Hogarth DK. Smoking cessation: the potential role of risk assessment tools as motivational triggers. Postgrad Med J. 2010;86:26–33.CrossRefPubMed Young RP, Hopkins RJ, Smith M, Hogarth DK. Smoking cessation: the potential role of risk assessment tools as motivational triggers. Postgrad Med J. 2010;86:26–33.CrossRefPubMed
10.
go back to reference McCaul KD, Hockemeyer JR, Johnson RJ, Zetocha K, Quinlan K, Glasgow RE. Motivation to quit using cigarettes: a review. Addict Behav. 2006;31:42–56.CrossRefPubMed McCaul KD, Hockemeyer JR, Johnson RJ, Zetocha K, Quinlan K, Glasgow RE. Motivation to quit using cigarettes: a review. Addict Behav. 2006;31:42–56.CrossRefPubMed
11.
go back to reference Kaleta D, Korytkowski PA, Makowiec-Dabrowska T, Usidame B, Bak-Romaniszyn L, Fronczak A. Predictors of long-term smoking cessation: Results from the global adult tobacco survey in Poland (2009-2010). BMC Public Health. 2012;12:1020.PubMedCentralCrossRefPubMed Kaleta D, Korytkowski PA, Makowiec-Dabrowska T, Usidame B, Bak-Romaniszyn L, Fronczak A. Predictors of long-term smoking cessation: Results from the global adult tobacco survey in Poland (2009-2010). BMC Public Health. 2012;12:1020.PubMedCentralCrossRefPubMed
12.
go back to reference Taylor KL, Cox LS, Zincke N, Mehta L, McGuire C, Gelmann E. Lung cancer screening as a teachable moment for smoking cessation. Lung Cancer. 2007;56:125–34.CrossRefPubMed Taylor KL, Cox LS, Zincke N, Mehta L, McGuire C, Gelmann E. Lung cancer screening as a teachable moment for smoking cessation. Lung Cancer. 2007;56:125–34.CrossRefPubMed
13.
go back to reference McBride CM, Emmons KM, Lipkus IM. Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res. 2003;18:156–70.CrossRefPubMed McBride CM, Emmons KM, Lipkus IM. Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res. 2003;18:156–70.CrossRefPubMed
15.
go back to reference Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347–65.CrossRefPubMed Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347–65.CrossRefPubMed
16.
go back to reference Gorecka D, Bednarek M, Nowinski A, Puscisnska E, Goljan-Geremek A, Zielinski J. Diagnosis of airflow limitation combined with smoking cessation advice increases stop smoking rate. Chest. 2003;123:1916–23.CrossRefPubMed Gorecka D, Bednarek M, Nowinski A, Puscisnska E, Goljan-Geremek A, Zielinski J. Diagnosis of airflow limitation combined with smoking cessation advice increases stop smoking rate. Chest. 2003;123:1916–23.CrossRefPubMed
17.
go back to reference Young RP, Hopkins R, Eaton TE. Forced expiratory volume in one second: not just lung function test but a marker of premature death from all causes. Eur Respir J. 2007;30:616–22.CrossRefPubMed Young RP, Hopkins R, Eaton TE. Forced expiratory volume in one second: not just lung function test but a marker of premature death from all causes. Eur Respir J. 2007;30:616–22.CrossRefPubMed
18.
go back to reference Peters EN, Hughes JR, Callas PW, Solomon LJ. Goals indicate motivation to quit smoking. Addiction. 2007;102:1158–63.CrossRefPubMed Peters EN, Hughes JR, Callas PW, Solomon LJ. Goals indicate motivation to quit smoking. Addiction. 2007;102:1158–63.CrossRefPubMed
19.
go back to reference Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE for the Lung Health Study Research Group. The Effects of a Smoking Cessation Intervention on 14.5-Year Mortality. A Randomized Clinical Trial. Ann Intern Med. 2005;142:233–9.CrossRefPubMed Anthonisen NR, Skeans MA, Wise RA, Manfreda J, Kanner RE, Connett JE for the Lung Health Study Research Group. The Effects of a Smoking Cessation Intervention on 14.5-Year Mortality. A Randomized Clinical Trial. Ann Intern Med. 2005;142:233–9.CrossRefPubMed
20.
go back to reference U.S. Preventive Services Task Force. Screening for chronic 2 obstructive pulmonary disease using spirometry: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148:529–34.CrossRef U.S. Preventive Services Task Force. Screening for chronic 2 obstructive pulmonary disease using spirometry: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148:529–34.CrossRef
21.
go back to reference Segnan N, Ponti A, Battista RN, Senore C, Rosso S, Shapiro SH, et al. A randomized trial of smoking cessation interventions in general practice in Italy. Cancer Causes Control. 1991;2:239–46.CrossRefPubMed Segnan N, Ponti A, Battista RN, Senore C, Rosso S, Shapiro SH, et al. A randomized trial of smoking cessation interventions in general practice in Italy. Cancer Causes Control. 1991;2:239–46.CrossRefPubMed
22.
go back to reference Buffels J, Degryse J, Decramer M, Heyrman J. Spirometry and smoking cessation advice in general practice: a randomised clinical trial. Respir Med. 2006;100:2012–7.CrossRefPubMed Buffels J, Degryse J, Decramer M, Heyrman J. Spirometry and smoking cessation advice in general practice: a randomised clinical trial. Respir Med. 2006;100:2012–7.CrossRefPubMed
23.
go back to reference Parkes G, Greenhalgh T, Griffin M, Dent R. Effect of smoking on quit rate of telling patients their lung age: The Step2quit randomized controlled trial. BMJ. 2008;336:598–600.PubMedCentralCrossRefPubMed Parkes G, Greenhalgh T, Griffin M, Dent R. Effect of smoking on quit rate of telling patients their lung age: The Step2quit randomized controlled trial. BMJ. 2008;336:598–600.PubMedCentralCrossRefPubMed
24.
go back to reference Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2013;5:CD000165.PubMed Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2013;5:CD000165.PubMed
25.
go back to reference Bize R, Burnand B, Mueller Y, Rège-Walther M, Camain JY, Cornuz J. Biomedical risk assessment as an aid for smoking cessation. Cochrane Database Syst Rev. 2012;12:CD004705.PubMed Bize R, Burnand B, Mueller Y, Rège-Walther M, Camain JY, Cornuz J. Biomedical risk assessment as an aid for smoking cessation. Cochrane Database Syst Rev. 2012;12:CD004705.PubMed
26.
go back to reference Rodriguez-Alvarez M, Toran-Monserrat P, Munoz-Ortiz L, Negrete-Palma A, Montero-Alia JJ, Jimenez-Gonzalez M, et al. Effectiveness of regular reporting of spirometric results combined with a smoking cessation advice by a primary care physician on smoking quit rate in adult smokers: a randomized controlled trial. ESPIROTAB study. BMC Fam Pract. 2011;12:61.PubMedCentralCrossRefPubMed Rodriguez-Alvarez M, Toran-Monserrat P, Munoz-Ortiz L, Negrete-Palma A, Montero-Alia JJ, Jimenez-Gonzalez M, et al. Effectiveness of regular reporting of spirometric results combined with a smoking cessation advice by a primary care physician on smoking quit rate in adult smokers: a randomized controlled trial. ESPIROTAB study. BMC Fam Pract. 2011;12:61.PubMedCentralCrossRefPubMed
27.
go back to reference Martin-Lujan F, Piñol-Moreso JL, Martin-Vergara N, Basora-Gallisa J, Pascual-Palacios I, Sagarra-Alamo R, et al. Effectiveness of a structured motivational intervention including smoking cessation advice and spirometry information in the primary care setting: the ESPITAP study. BMC Public Health. 2011;11:859.PubMedCentralCrossRefPubMed Martin-Lujan F, Piñol-Moreso JL, Martin-Vergara N, Basora-Gallisa J, Pascual-Palacios I, Sagarra-Alamo R, et al. Effectiveness of a structured motivational intervention including smoking cessation advice and spirometry information in the primary care setting: the ESPITAP study. BMC Public Health. 2011;11:859.PubMedCentralCrossRefPubMed
29.
go back to reference Heatherton TF, Kozlowski LT, Frecker RC, Fageström KO. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict. 1991;86:1119–27.CrossRefPubMed Heatherton TF, Kozlowski LT, Frecker RC, Fageström KO. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict. 1991;86:1119–27.CrossRefPubMed
30.
go back to reference Richmond RL, Kehoe LA, Webster IW. Multivariate models for predicting abstention following intervention to stop smoking by general practitioners. Addiction. 1993;88:1127–35.CrossRefPubMed Richmond RL, Kehoe LA, Webster IW. Multivariate models for predicting abstention following intervention to stop smoking by general practitioners. Addiction. 1993;88:1127–35.CrossRefPubMed
31.
go back to reference Prochaska J, DiClemente C. Stages and process of self-change of smoking: towards and integrative model of change. J Consult Clin Psychol. 1983;51:390–5.CrossRefPubMed Prochaska J, DiClemente C. Stages and process of self-change of smoking: towards and integrative model of change. J Consult Clin Psychol. 1983;51:390–5.CrossRefPubMed
32.
go back to reference Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–38.CrossRefPubMed Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–38.CrossRefPubMed
34.
go back to reference Morris JF, Temple W. Spirometric “lung age” estimation for motivating smoking cessation. Prev Med. 1985;14:655–62.CrossRefPubMed Morris JF, Temple W. Spirometric “lung age” estimation for motivating smoking cessation. Prev Med. 1985;14:655–62.CrossRefPubMed
35.
go back to reference Hughes J, Keely J, Niaura R, Ossip-Klein D, Richmond R, Swan G. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res. 2003;5:13–26.CrossRefPubMed Hughes J, Keely J, Niaura R, Ossip-Klein D, Richmond R, Swan G. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res. 2003;5:13–26.CrossRefPubMed
36.
go back to reference SRNT Subcommittee on Biochemical Verification. Biochemical verification of tobacco use and cessation. Nicotine Tob Reser. 2002;4:149–59.CrossRef SRNT Subcommittee on Biochemical Verification. Biochemical verification of tobacco use and cessation. Nicotine Tob Reser. 2002;4:149–59.CrossRef
37.
go back to reference Akl EA, Briel M, You JJ, Lamontagne F, Gangji A, Cukierman-Yaffe T, et al. LOST to follow-up Information in Trials (LOST-IT): a protocol on the potential impact. Trials. 2009;10:40.PubMedCentralCrossRefPubMed Akl EA, Briel M, You JJ, Lamontagne F, Gangji A, Cukierman-Yaffe T, et al. LOST to follow-up Information in Trials (LOST-IT): a protocol on the potential impact. Trials. 2009;10:40.PubMedCentralCrossRefPubMed
38.
go back to reference Caponnetto P, Polosa R. Common predictors of smoking cessation in clinical practice. Respir Med. 2008;102:1182–92.CrossRefPubMed Caponnetto P, Polosa R. Common predictors of smoking cessation in clinical practice. Respir Med. 2008;102:1182–92.CrossRefPubMed
40.
go back to reference Bucher HC, Griffith LE, Guyatt GH. Systematic review on the risk and benefit of different cholesterol-lowering interventions. Arterioscler, Thromb, Vasc Biol. 1999;19:187–95.CrossRef Bucher HC, Griffith LE, Guyatt GH. Systematic review on the risk and benefit of different cholesterol-lowering interventions. Arterioscler, Thromb, Vasc Biol. 1999;19:187–95.CrossRef
41.
go back to reference Bovet P, Perret F, Cornuz J, Quilindo J, Paccaud F. Improved smoking cessation in smokers given ultrasound photographs of their own atherosclerotic plaques. Prev Med. 2002;34:215–20.CrossRefPubMed Bovet P, Perret F, Cornuz J, Quilindo J, Paccaud F. Improved smoking cessation in smokers given ultrasound photographs of their own atherosclerotic plaques. Prev Med. 2002;34:215–20.CrossRefPubMed
42.
go back to reference Lin K, Watkins B, Johnson T, Rodriguez JA, Barton MB, U.S. Preventive Services Task Force. Screening for chronic obstructive pulmonary disease using spirometry: summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;148:535–43.CrossRefPubMed Lin K, Watkins B, Johnson T, Rodriguez JA, Barton MB, U.S. Preventive Services Task Force. Screening for chronic obstructive pulmonary disease using spirometry: summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;148:535–43.CrossRefPubMed
43.
go back to reference Kotz D, Wesseling G, Huibers MJ, van Schayck OC. Efficacy of confronting smokers with airflow limitation for smoking cessation. Eur Respir J. 2009;33:754–62.CrossRefPubMed Kotz D, Wesseling G, Huibers MJ, van Schayck OC. Efficacy of confronting smokers with airflow limitation for smoking cessation. Eur Respir J. 2009;33:754–62.CrossRefPubMed
44.
go back to reference Kotz D, Vos R, Huibers MJ. Ethical analysis of the justifiability of labelling with COPD for smoking cessation. J Med Ethics. 2009;35:534–40.CrossRefPubMed Kotz D, Vos R, Huibers MJ. Ethical analysis of the justifiability of labelling with COPD for smoking cessation. J Med Ethics. 2009;35:534–40.CrossRefPubMed
Metadata
Title
Multicentric randomized clinical trial to evaluate the long-term effectiveness of a motivational intervention against smoking, based on the information obtained from spirometry in primary care: the RESET study protocol
Authors
Francisco Martin-Lujan
Antoni Santigosa-Ayala
Josep-Lluis Piñol-Moreso
Mar Sorli-Aguilar
Gemma Flores-Mateo
Jordi Bladé-Creixenti
Josep Basora-Gallisà
Rosa Sola-Alberich
for the RESET Study Group investigators
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0415-1

Other articles of this Issue 1/2016

BMC Primary Care 1/2016 Go to the issue