Spirometric ‘lung age’ can encourage smokers to quit

Spirometric testing to determine patients’ ‘lung age’ can be a powerful tool in assisting them to quit smoking, a randomised controlled trial has concluded. The trial, based in five English general practices, tested 561 smokers older than 35 using standard spirometry. All were given advice to stop smoking and half were simply told their FEV1 and advised that they would be retested in a year to check for any changes in their lung function. The other half had a discussion about their spirometry results, and the age of healthy non-smokers who would be expected to perform the same as them: in other words, they were given an estimated of their ‘lung age’, and it was often many years older than the patient. In the intervention group 13.6% had stopped smoking at 12 months, as confirmed by salivary cotinine testing, compared to only 6.4% in the control group. There were no differences in the incidence of newly-diagnosed chronic obstructive pulmonary disease. Patients who were told their lung age was ‘normal’ were just as likely to quit as patients who were told their lungs were prematurely aged. The researchers said this might have been a result of an inadequate sample size, but it more likely reflected the complicated mix of psychological and circumstantial factors that affected smoking cessation. For some people, the news that they still had relatively healthy lungs meant it was “not too late to quit”, while a diagnosis of prematurely aged lungs might confirm their fatalism and a perception that quitting would make little difference. For others, the reverse pattern might apply. The results suggested that spirometry should be used early as a tool in counselling patients about smoking. “Spirometry can detect obstructive lung damage after 20 pack years of smoking, typically at around age 35,” they said. “Yet the average age of diagnosis of COPD in the UK is 55, despite widespread availability of diagnostic equipment.” Reference...