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The effect of reducing the threshold for carbon monoxide validation of smoking abstinence - Evidence from the English Stop Smoking Services

Brose, LS; Tombor, I; Shahab, L; West, R; (2013) The effect of reducing the threshold for carbon monoxide validation of smoking abstinence - Evidence from the English Stop Smoking Services. Addictive Behaviors , 38 (10) 2529 - 2531. 10.1016/j.addbeh.2013.04.006. Green open access

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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 (< 10 ppm) that also met lower thresholds was calculated for each unit change from < 9 ppm to < 2 ppm. Additionally, associations of established predictors with outcome were assessed in logistic regressions for selected thresholds. / Results: At < 10 ppm, 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. < 8 ppm: 34.7% success), but at < 3 ppm, only 26.3% would still be regarded as successful. With the threshold reduced to < 3 ppm established predictors of cessation showed a weaker association with outcome than with the threshold at < 10 ppm 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.

Type: Article
Title: The effect of reducing the threshold for carbon monoxide validation of smoking abstinence - Evidence from the English Stop Smoking Services
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.addbeh.2013.04.006
Publisher version: http://dx.doi.org/10.1016/j.addbeh.2013.04.006
Language: English
Additional information: © 2013. This manuscript version is published under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International licence (CC BY-NC-ND 4.0). This licence allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licences are available at http://creativecommons.org/licenses/by/4.0.
Keywords: Carbon monoxide, Outcome criteria, Smoking cessation, Success rates, Biological Markers, Breath Tests, Carbon Monoxide, England, Humans, Logistic Models, Outcome Assessment (Health Care), Preventive Health Services, Sensitivity and Specificity, Smoking, Smoking Cessation
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/1398173
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