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The Impact of Carotid Plaque Screening  on Motivation for Smoking Cessation  and Knowledge Retention  About Atherosclerosis Nicolas Rodondi, MD, MAS, Reto Auer, MD,  Patrick J. Devine, MD, Patrick G. O’Malley, MD, MPH,  Daniel Hayoz, MD, Jacques Cornuz, MD, MPH Consultation de Prévention Cardiovasculaire & Consultation des Lipides  Policlinique Médicale Universitaire Université de Lausanne
Background (1) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],1  PG O’Malley,  Arch Intern Med  2006 2  NHLBI subclinical diseas working group 2004
Background (2)  ,[object Object],[object Object],1  PG O’Malley,  Arch Intern Med  2006 2   P Greenland,  JAMA  2003 3  R Bize,  Cochrane Database  2005
RCT of carotid US on smoking cessation at 6 months (n=153) P  value : (A vs B+C [17.6%]) = 0.031 (A+B vs C) = 0.003 Bovet P et al. , Prev Medicine  2002  ,[object Object],[object Object],[object Object],[object Object],%
[object Object],[object Object],[object Object],[object Object],Background (3)
Pilot study before  a large RCT: Objectives ,[object Object],[object Object]
Methods (1) : Design and participants ,[object Object],[object Object],[object Object]
Methods (2): Intervention ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],1  Oei HH,  J Am Coll Cardiol  2002 2  Redberg RF,  J Am Coll Cardiol   2003
Methods (3) : Outcomes  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pilot Study: Participant Characteristics (n=30) Variable Mean (± SD) or % Mean age [range], yr 51.7  ± 9.4 [40 – 70] Women 43.3 % Daily cigarette consumption 22.2  ± 9 Pack-year smoking history 38.3  ± 19.3 Previous attempts of smoking cessation 83.3 % By attempters (n=25), number of previous attempts of smoking cessation   3.1 ± 2.2 [1-10]  Fagerström score 4.8  ± 2.3
Smoking cessation at two months Motivation for smoking cessation, 1-10 Pre-screening 72.7% 37.5% Smoking cessation  at 2 months, % 7.9 No plaque Plaque No plaque (n=8) Plaque (n=22) Pre-screening At 2 months At 2 months P = 0.10 P = 1.0 P = 0.008 7.2 8.7 At 2 months At 2 months N Rodondi et al,  Nicotine & Tobacco Research  2008
Baseline At two months P Stress  Perceived 4-Item stress scale,  2.0 [0-5] 1.5 [0-3.5] 0.13 range 0-16 Group without carotid plaques 1.0 [0-2.5] 2 [0-3.5] 0.66 Group with carotid plaques 2.5 [1-5.5] 0.5 [0-3.5] 0.04 Anxiety , range 0-14, Prime-MD  4.0 [0-7.5] 2.0 [0-4.0] 0.01 Group without range carotid plaques 4.0 [2.0-5.5] 1.5 [0.5-4.0] 0.11 Group with carotid plaques 3.5 [0-8.0] 2.0 [0-4.0] 0.04 Depression , range 0-27, Prime-MD  4.0 [2.0-6.5] 3.0 [0.5-4.5] 0.02 Group without range carotid plaques 6.0 [4.0-7.5] 3.5 [0.5-5.0] 0.08 Group with carotid plaques 4.0 [2.0-6.0] 3.0 [1.0-4.5] 0.12 Potential harms of screening Range 1-10, median [25%-75%]  N Rodondi et al,  Nicotine & Tobacco Research  2008
Knowledge Retention About Atherosclerosis ,[object Object],[object Object],[object Object],[object Object]
Limitations ,[object Object],[object Object],[object Object]
Design of the ongoing RCT in 530 smokers 530 smokers aged 40-70 y  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],No test ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],R Outcomes at 1 year Outcomes at 1 year Abbreviations: US: ultrasound, BP: blood pressure, CRP: C-reactive protein ®  = randomization Support This clinical trial is supported by the  Swiss National Foundation and the Swiss heart Foundation .
Conclusions ,[object Object],[object Object],[object Object]
[email_address]

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The Impact of carotid plaque screening on motivation for smoking cessation and knowledge retention about atherosclerosis

  • 1. The Impact of Carotid Plaque Screening on Motivation for Smoking Cessation and Knowledge Retention About Atherosclerosis Nicolas Rodondi, MD, MAS, Reto Auer, MD, Patrick J. Devine, MD, Patrick G. O’Malley, MD, MPH, Daniel Hayoz, MD, Jacques Cornuz, MD, MPH Consultation de Prévention Cardiovasculaire & Consultation des Lipides Policlinique Médicale Universitaire Université de Lausanne
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  • 10. Pilot Study: Participant Characteristics (n=30) Variable Mean (± SD) or % Mean age [range], yr 51.7 ± 9.4 [40 – 70] Women 43.3 % Daily cigarette consumption 22.2 ± 9 Pack-year smoking history 38.3 ± 19.3 Previous attempts of smoking cessation 83.3 % By attempters (n=25), number of previous attempts of smoking cessation 3.1 ± 2.2 [1-10] Fagerström score 4.8 ± 2.3
  • 11. Smoking cessation at two months Motivation for smoking cessation, 1-10 Pre-screening 72.7% 37.5% Smoking cessation at 2 months, % 7.9 No plaque Plaque No plaque (n=8) Plaque (n=22) Pre-screening At 2 months At 2 months P = 0.10 P = 1.0 P = 0.008 7.2 8.7 At 2 months At 2 months N Rodondi et al, Nicotine & Tobacco Research 2008
  • 12. Baseline At two months P Stress Perceived 4-Item stress scale, 2.0 [0-5] 1.5 [0-3.5] 0.13 range 0-16 Group without carotid plaques 1.0 [0-2.5] 2 [0-3.5] 0.66 Group with carotid plaques 2.5 [1-5.5] 0.5 [0-3.5] 0.04 Anxiety , range 0-14, Prime-MD 4.0 [0-7.5] 2.0 [0-4.0] 0.01 Group without range carotid plaques 4.0 [2.0-5.5] 1.5 [0.5-4.0] 0.11 Group with carotid plaques 3.5 [0-8.0] 2.0 [0-4.0] 0.04 Depression , range 0-27, Prime-MD 4.0 [2.0-6.5] 3.0 [0.5-4.5] 0.02 Group without range carotid plaques 6.0 [4.0-7.5] 3.5 [0.5-5.0] 0.08 Group with carotid plaques 4.0 [2.0-6.0] 3.0 [1.0-4.5] 0.12 Potential harms of screening Range 1-10, median [25%-75%] N Rodondi et al, Nicotine & Tobacco Research 2008
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