Table 1.
Summary of studies testing behavioral interventions for smoking cessation in patients with chronic obstructive pulmonary disease.
| Authors (Year) | Conditions Compared | Sample Characteristics | Baseline Lung Function | Duration of Intervention | Outcome | Results |
|---|---|---|---|---|---|---|
| Lou et al. (2013) | Usual care plus educational materials. | N=1,748; age range=~40-80 yr; 51.9% women; education level= 8.7% “high”, 18.5% “middle”, 72.8% “low”; household income= 8.4% “high”, 83.9% “middle”, 7.7% “low” | MRC=0 (5.1%), 1 (19.8%), 2 (28.5%), 3 (27.8%), 4 (18.8%) | 2 yr | Self-reported smoking status plus biochemically confirmed sustained abstinence between 24-30 mo (breath CO ≤10 ppm) | Rate of sustained abstinence was higher for participants in the intervention (46.4%) vs. usual care (3.4%) (P<.001). |
| Intervention: intensive individual and group counseling plus educational materials. | N=1,814; age range=~40-80 yr; 52.1% women; education level=8.8% “high”, 18.0% “middle”, 73.2% “low”; household income= 8.2% “high”, 84.3% “middle”, 7.5% “low” | MRC=0 (5.0%), 1 (19.7%), 2 (28.9%), 3 (27.7%), 4 (18.7%) | ||||
| Streck et al. (2018) | Control: non-contingent vouchers (i.e., delivery of monetary vouchers independent of smoking status). | N=16; Age 57.9 ±8.1 yr; 50% women; yr of education= 12.8 ±2.9 | Postbronchodilator FEV1/FVC 59.9 ± 11.6% | 2 wk | Biochemically confirmed abstinence between 1-5 d (breath CO ≤ 6 ppm) and 6-14 d (urine cotinine ≤80 ng/mL) | Except for 12 d, abstinence rates were higher for participants in the intervention (~40%) vs. control (~10%) on 9-14 d (P<.05). No differences between conditions on 1-8 d. |
| Intervention: contingent vouchers (delivery of vouchers dependent on biochemically verified abstinence, escalating schedule ($9.00 + 1.50 for each subsequent negative sample), temporary reset back to $0 for positive or missing samples. | N=13; Age 55.8 ±6.8 yr; 46% women; yr of education= 12.8±1.8 | Postbronchodilator FEV1/FVC 52.4 ±13.3% | ||||
| Wilson et al. (2008) | Usual care | N=35; Age 61.4 ±8 yr; 49% women; education and household income not reported | FEV1 54.3 ±20.0% | 5 wk | Biochemically confirmed abstinence at 1-yr follow-up (breath CO ≤10 ppm; saliva cotinine ≤10 ng/mL) | No difference between conditions. |
| Intervention 1: individual counseling (one-to-one sessions between patient and nurse), optional NRT. | N=27; Age 61.0 ±8 yr; 48% women; education and household income not reported | FEV1 52.1 ±20.0% | ||||
| Intervention 2: group counseling (group of patients and 2 nurses), optional NRT. | N=29; Age 60.4 ± 9 yr; 59% women; education and household income not reported | FEV1 54.6 ± 23.0 % |
Note: All studies summarized in Table 1 used randomized controlled trials.
Abbreviations: MRC, Medical Research Council Dyspnea Scale (higher values indicate greater dyspnea); FEV1, Forced Expiratory Volume during 1st sec of forced expiration; FVC, Forced Vital Capacity; NRT, Nicotine Replacement Therapy.
“Usual care” for smoking cessation generally consists of low-intensity health education, simple smoking cessation advice, and encouragement to quit smoking.
Data presented as mean ± SD