Effect of incorporating a 10 minute point of care test for salivary nicotine metabolites into a general practice based smoking cessation programme: randomised controlled trial
BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.38621.463900.7C (Published 27 October 2005) Cite this as: BMJ 2005;331:999
- Kristian D Barnfather, general dental surgeon1,
- Graham F Cope, research fellow2,
- Iain L Chapple, professor of periodontology (I.L.C.Chapple{at}bham.ac.uk)3
- 1General Practice, 6 Harcourt House, London W1G 0PN
- 2Wolfson Applied Technology Laboratory, Queen Elizabeth Medical Centre, Edgbaston, Birmingham B15 2TH
- 3Periodontal Research Group, University of Birmingham, St Chad's Queensway, Birmingham B4 6NN
- Correspondence to: I L Chapple
- Accepted 10 August 2005
Abstract
Objective To investigate the effect of immediate feedback from a point of care test for salivary nicotine metabolites in promoting smoking cessation and reduction in tobacco use.
Design Prospective, operator blinded, randomised controlled trial.
Setting General dental practice, London.
Participants 100 adult smokers.
Interventions Participants completed a questionnaire on smoking, undertook a clinical examination, and received counselling in smoking cessation. Saliva samples were analysed at presentation and at eight weeks for salivary nicotine metabolites using a 10 minute semiquantitative point of care test.
Main outcome measures Smoking cessation measured by salivary nicotine metabolite values (scale 0-6), patient feedback on the perceived value of the test (visual analogue scale) in quitting, and reduction in tobacco use.
Results A higher smoking quit rate was achieved with the point of care test (23% cases v 7% controls; P < 0.039), and overall tobacco use also decreased (68% cases v 28% controls; P < 0.001). Baseline values for salivary nicotine metabolites did not differ between the groups (cases, mean 4.1, SD 1.3 and 4.3, 1.4; P = 0.51). 87 participants reattended at eight weeks (44 cases, 43 controls). Mean nicotine metabolite values at eight weeks were 2.58 (2.0) for cases and 4.29 (1.8) for controls (P < 0.001).
Conclusion Incorporation of individualised personal feedback using a point of care test for salivary nicotine metabolites into a general practice based smoking cessation programme increased quit rates by 17% at eight weeks and reduced tobacco use.
Footnotes
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Table showing percentage changes in smoking is on bmj.com -
Contributors All authors contributed to the planning, evaluation, and reporting of this study and will act as guarantors. KDB undertook all clinical work, established and carried out the study, secured funding, and wrote the first draft of the manuscript. ILC was responsible for the conception of the project, study design, data analysis and interpretation, and preparation of the manuscript. GFC was responsible for the study design, training and calibration of the investigator, laboratory backup and calibration, and preparation of the manuscript. The Oral and Dental Research Trust provided some funding for the study, which was an award, made on a competitive basis.
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Funding This work was supported by a grant from the Oral and Dental Research Trust, British Society for Dental Research.
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Competing interests GFC was an employee of the founding company (Mermaid Diagnostics) that manufactured the assay device and is currently employed by Surescreen Diagnostics, the current manufacturer. His role in this study was as an adviser in the establishment of protocols for using the device and the scientific background to usage of the device. He was not involved in data analysis or its interpretation, but proof read the manuscript and made valuable contributions to its accuracy.
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Ethical approval This study received ethical approval from the Riverside research ethics committee, London.
- Accepted 10 August 2005