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Publication Detail
The effect of reducing the threshold for carbon monoxide validation of smoking abstinence--evidence from the English Stop Smoking Services.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Journal Article
  • Authors:
    Brose LS, Tombor I, Shahab L, West R
  • Publication date:
    10/2013
  • Pagination:
    2529, 2531
  • Journal:
    Addict Behav
  • Volume:
    38
  • Issue:
    10
  • Status:
    Published
  • Country:
    England
  • PII:
    S0306-4603(13)00125-1
  • Language:
    eng
  • Keywords:
    Carbon monoxide, Outcome criteria, Smoking cessation, Success rates, Biomarkers, Breath Tests, Carbon Monoxide, England, Humans, Logistic Models, Outcome Assessment, Health Care, Preventive Health Services, Sensitivity and Specificity, Smoking, Smoking Cessation, Smoking Prevention
Abstract
INTRODUCTION: The most commonly used threshold of expired-air carbon monoxide (CO) concentration to validate self-reported smoking abstinence is <10 parts per million (ppm). It has been proposed to reduce this threshold. This study examined what effect a reduction would have on short-term success rates in clinical practice. METHODS: A total of 315,718 quit attempts supported by English NHS Stop Smoking Services were included in the analysis. The proportion of 4-week quits as determined by the Russell standard (<10ppm) that also met lower thresholds was calculated for each unit change from <9ppm to <2ppm. Additionally, associations of established predictors with outcome were assessed in logistic regressions for selected thresholds. RESULTS: At <10ppm, 35% of quit attempts were regarded as successful. Differences for a single unit reduction increased with each reduction; small reductions had very little impact (e.g. <8ppm: 34.7% success), but at <3ppm, only 26.3% would still be regarded as successful. With the threshold reduced to <3ppm established predictors of cessation showed a weaker association with outcome than with the threshold at <10ppm suggesting an increase in error of outcome measurement. CONCLUSIONS: Reducing the threshold for expired-air CO concentration to validate abstinence would have a minimal effect on success rates unless the threshold were reduced substantially which would likely increase error of measurement.
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