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Causation
Multiple attempts to stop smoking, even with relapses, reduced loss of pulmonary function

https://doi.org/10.1136/ebn.2.3.90

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    Murray RP, Anthonisen NR, Connett JE, et al for the Lung Health Study Research Group. Effects of multiple attempts to quit smoking and relapses to smoking on pulmonary function.J Clin Epidemiol1998 Dec; 51:1317–26.OpenUrlCrossRefPubMedWeb of Science

    Question What are the effects of multiple failed attempts to stop smoking on pulmonary function of adults?

    Design

    Retrospective analysis of a cohort of participants involved in a randomised controlled trial (Lung Health Study), with annual follow up for 5 years.

    Setting

    10 clinical centres in North America.*

    Participants

    5887 adults aged 35–60 years, who smoked and had evidence of early chronic obstructive pulmonary disease (ie, had an FEV1/FVC [forced expiratory volume at 1 sec/forced vital capacity] interval of ≤70%, and an FEV1 of 55–90% of predicted normal).

    Assessment of risk factors

    Smoking status was assessed at baseline and at 5 annual visits thereafter. Participant reports of abstinence were confirmed by salivary cotinine concentrations (<20 ng/ml) or if nicotine substitution therapy was used, by CO concentrations (<10 ppm in end tidal …

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    Footnotes

    • Sources of funding: Division of Lung Diseases of the National Heart, Lung, and Blood Institute; Boehringer Ingelheim Pharmaceutical, Marion Merrell Dow, and Merrell Dow Pharmaceuticals (Canada) contributed drugs used by the study.

    • For correspondence: Dr R P Murray, Section of Clinical Epidemiology and Outcome Evaluation, Room MS754, Health Sciences Centre, University of Manitoba, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada. Fax +1 204 789 3905.

    • ↵* Anthonisen NR, Connett JE, Kiley JP, et al for the Lung Health Study Research Group. JAMA 1994;272:1497–505.