Giving smokers information about their own individual risk of serious illness helps motivate them to quit smoking, according to a paper published in the current issue of Postgraduate Medical Journal.
"Personalized risk assessment has been the mainstay of coronary artery disease prevention and has resulted in significant mortality reduction over the last decade," said Dr. Robert Young, lead author of the article. "Such an approach could be equally applied to smoking cessation, now that we have predictive risk assessment tools that identify those at greatest risk of lung-related illness from smoking."
Though about half of long-term smokers die from smoking-related disease, and 50% of those deaths will come from lung cancer or chronic lung disease, many smokers believe they will be the ones who will escape unharmed; they carry on smoking or they try but fail to quit.
The PMJ article endorses a new model for smoking cessation to help doctors engage smokers more effectively by using what it calls 'motivational tension' - anxiety based on a smoker's perception of harms versus benefits. Health concerns are an important factor in motivating smokers to quit; smoking cessation rates appear to be greatest where smokers have suffered, or been shown to be personally at risk of, life threatening complications from their smoking.
In this setting, risk assessment tools that identify those at greatest risk, such as spirometry (a puff test to measure lung function) and genetic susceptibility testing, appear to help engage smokers and improve their smoking cessation rates. When smokers see their individual risk as a result of lung function or genetic tests, that new personalised information is likely to trigger a quit attempt, and will make that quit attempt more likely to succeed. This is very similar to cholesterol and blood pressure testing in the context of cardiovascular risk assessment and treatment.
According to studies cited in the article, genetic testing for smoking-related disease demonstrated utility for all smokers and found no evidence of fatalism in higher risk people or reduced motivation for those at lower risk levels.