CHEST 2011: Embargoed studies highlight new tobacco cessation research

It is well known that smoking leads to a reduction in levels of fractional exhaled nitric oxide (FeNO), which is a marker for airway inflammation. However, there is limited knowledge about smoking-induced changes in the production and exchange of nitric oxide (NO) in young adults. In a study of eight women and eight men with a mean age of 23 years and a smoking history of less than eight pack-years, Greek researchers found that after smoking a single cigarette, the airway tissue concentration of NO increased by 26%, and the FeNO levels decreased by 15.6%. This reduction can lead to a limited flux of NO in the airways of young adults, significantly impairing health. This research demonstrates the negative impact of smoking even one cigarette, especially in young people.

Computer Model Predicts Smoking Cessation Success by Treatment Type
(#1113245, Wednesday, October 26, 5:30 PM Eastern)

Researchers from the Clemson University in South Carolina and the University of North Carolina in Chapel Hill developed a computer-aided model to evaluate the cost-effectiveness of various smoking cessation treatments. Based on their simulation model, patients who received nicotine replacement therapy had an 87% tendency to relapse at 1 year and have a 93% chance at 30 years. Of those who received other therapies, such as bupropion and varenicline, 78% were still smoking at 1 year and 89% remained smokers at 30 years. Of those who quit unassisted, 95% tended to return to prior behaviors at 1 year and 98% at 30 years. The average cost per quality-adjusted life year saved was greater at 30 years for all three treatment groups compared with those who quit unassisted. Smoking cessation treatments increase the probability of patients quitting smoking. The long-term health benefits to patients and the reduced economic burden to society outweigh intervention costs.

Cold Turkey Smoking Cessation Advice Reflects Poor Success Rate
(#1112654, Wednesday, October 26, 5:30 PM Eastern)

Clinicians frequently recommend patients stop smoking but do not always provide them with appropriate tools to ensure their success. Researchers from the Medical University of South Carolina in Charleston conducted a survey of 777 current and ex-smokers, asking questions about patient demographics, smoking status, smoking cessation attempts, physician recommendations regarding approaches, and methods used to stop smoking, as well as cessation treatments. Among current smokers, 66% were advised by a physician to stop smoking. A cold turkey approach was advised 19% of the time, while nicotine replacement therapy was advised 52% of the time, and medications were advised 40% of the time. Of those who received a recommendation to quit cold turkey, the success rate was less than 10% a year. Greater efforts may be required by clinicians to ensure patients receive appropriate evidence-based therapy for smoking cessation.

Fewer Hospitals Offering Smoking Cessation Programs
(#1119865, Tuesday, October 25, 3:00 PM Eastern)

The number of hospital-based smoking cessation programs available to the public has decreased. In 2011, researchers from Robert Wood Johnson Medical School/University of Medicine and Dentistry of New Jersey, and St. Peter's University Hospital in New Brunswick, New Jersey found a 50% decline in hospitals offering smoking cessation programs to the public compared with results of a prior survey conducted in 2000. Of the 28 hospitals contacted in 2000, researchers were able to reach 20 in 2011. Of those, only seven had smoking cessation programs available; only three of those programs were in-hospital. The others offered only toll-free quit line phone numbers. Overall, 35% of hospitals demonstrated easy access to their public smoking cessation programs. The hospitals in this sample are doing worse in terms of offering smoking cessation to their surrounding populations.

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