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Smokers More Likely to Quit if Told Lung Age
> 3/11/2008 1:50:53 PM

General practitioners often advise their patients to give up smoking, but even when they warn of a myriad of health problems exacerbated by cigarettes, their patients rarely quit. The March issue of the British Medical Journal contains an evaluation of a surprisingly simple and effective way to boost the impact of a doctor's orders.

People don't always make the healthiest choices. Doctors would have a lot less business if they did. Patients often need a shock to jar them out of unhealthy habits; for some, it takes a heart-attack to finally push them to give up fast food. Luckily, it turns out that smokers can be prodded with a far less dramatic event�a disclosure of "lung age"�. Dr. Gary Parkes used a spirometer to test the lung function of subjects, and then translated those numbers into the age when function normally degenerates to that level. Approximately one fourth of smokers have abnormally aged lungs.

The subjects were divided into two groups. Both groups were evaluated with a spirometer and advised to quit, but the control group was simply informed of their results in liters per second while the intervention group received a lung age. This might seem like a trifling difference, but it had an immense impact. When subjects were tested one year later for chemical traces of smoking, only 6.4% of the control group were smoke-free, while 13.6% of the intervention group had quit.

The obvious conclusion would be that hearing that their lungs were suffering accelerated senescence was frightening enough to make subjects give up their habit. However, subjects were actually equally likely to quit regardless of whether their lung age was higher than their objective age. It seems that simply contemplating the way that smoking can accelerate aging is enough motivation.

Dr. Parkes scrupulously outlines why the intervention in his study would be both life-saving and cost-effective. Using time and salary estimates, he calculated that the cost of spirometer testing for all smokers would come out to just $556 per quitter. As each smoker requires many thousands more dollars in healthcare during a lifetime, this intervention makes clear economic sense. As a bonus (a big bonus), spirometer checks also screen for chronic obstructive pulmonary disease, the forth most most common killer in the United States.

There are many pharmaceutical and therapeutic methods available for those who want to quit, but general practitioners are the first, and sometimes only, places from which many people are willing to accept help. The 13.6% achieved from a simple test and reframing of risk is impressive. For comparison, the nicotine patch has a success rate around 7%, barely above placebo. One lesson to take away from this study is that it is not enough to present abstract numbers or deliver general admonitions that smoking is unhealthy. Well-crafted, emotionally-charged examples of what smoking can do to your body are much more likely to spur smokers to quit.

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