title: The impact of carotid plaque screening on motivation for smoking cessation.
abstract: Showing smokers their own atherosclerotic plaques might increase motivation for smoking cessation, since they underestimate their own risk for smoking-related diseases. To assess the feasibility and optimal processes of studying the impact of carotid atherosclerotic plaque screening in smokers, we enrolled 30 daily cigarette smokers, aged 40-70 years, in an observational pre-post pilot study. All smokers underwent smoking cessation counseling, nicotine replacement therapy, a carotid ultrasound, an educational tutorial on atherosclerosis, baseline and 2-month motivation to change assessment, and assessment of smoking cessation at 2 months. Participants had a mean smoking duration of 34 years (SD = 7). Carotid plaques were present in 22 smokers (73%). Between baseline and 2 months after plaque screening, motivation for smoking cessation increased from 7.4 to 8.4 out of 10 (p = .02), particularly in those with plaques (7.2 to 8.7, p = .008). At 2 months, the smoking quit rate was 63%, with a quit rate of 73% in those with plaques vs. 38% in those without plaques (p = .10). Perceived stress, anxiety, and depression did not increase after screening. 96% of respondents answered correctly at least 80% of questions regarding atherosclerosis knowledge at baseline and after 2 months. In conclusion, studying the process of screening for carotid plaques for the purpose of increasing motivation for smoking cessation, in addition to counseling and drug therapy for smoking cessation in long-term smokers, appears feasible. The impact of carotid plaque screening on smoking cessation should be examined in larger randomized controlled trials with sufficient power to assess the impact on long-term smoking cessation rates.
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland. nicolas.rodondi@hospvd.ch
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.forename: Reto
authors.initials: R
authors.lastname: Auer
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Devine
authors.forename: Patrick G
authors.initials: PG
authors.lastname: O'Malley
authors.forename: Daniel
authors.initials: D
authors.lastname: Hayoz
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000523:psychology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D003376:Counseling / Q000379:methods*; D003863:Depression / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010865:Pilot Projects; D012307:Risk Factors; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D014463:Ultrasonography