Assessment of a Personal Interactive Carbon Monoxide Breath Sensor in People Who Smoke Cigarettes: Single-Arm Cohort Study.
Assessment of a Personal Interactive Carbon Monoxide Breath Sensor in People Who Smoke Cigarettes: Single-Arm Cohort Study.
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DOI：
10.2196/22811
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发表时间：
2020-10-02
影响因子：
7.4
通讯作者：
Utley DS
中科院分区：
文献类型：
--
作者：
Marler JD;Fujii CA;Wong KS;Galanko JA;Balbierz DJ;Utley DS
烟草使用是可预防的发病率和死亡率的主要原因。现有的循证治疗方法没有得到充分利用，最近几乎没有看到创新。个人生物反馈干预在其他疾病状态的成功预示着戒烟的类似机会。Pivot呼气传感器是一种个人交互式(FDA批准)(非处方)设备，可以测量呼气中的一氧化碳(CO)，使用户能够将他们的吸烟行为和CO值联系起来，并跟踪他们减少或戒烟的进展。这项研究的目的是评估吸烟者的Pivot呼气传感器，评估戒烟态度、吸烟行为和使用体验的变化。美国成年人(18-80岁，≥每天抽10支香烟[CPD])在网上招募参加这项为期12周的远程研究。参与者完成了筛查电话、知情同意和基线问卷，然后邮寄了他们的传感器。参与者被要求每天提交4份或更多呼吸样本，并在1-4周、8周和12周完成问卷调查。结果包括对戒烟的态度(戒烟的阶段、戒烟的成功程度和戒烟的难度)、吸烟行为(戒烟尝试、CPD减少和7-30天的时点戒烟[PPA])和使用经验(影响和学习)。研究对象包括234名吸烟者，平均年龄39.9(SD 11.3)岁，52.6%(123/234)女性，平均CPD 20.3(SD 8.0)。为期4周和12周的问卷调查完成率分别为92.3%(216/234)和91.9%(215/234)。在态度结果方面，基线时，15.4%(36/234)的人认真考虑在未来30天内戒烟，4周时为38.9%(84/216)，12周时为47.9%(103/215)(P均<0.01)。12周时戒烟动机增加39.1%(84/215)，不变54.9%(118/215)，减少6.0%(13/215；P<；.001)。对戒烟的其他态度从基线改善到12周：戒烟成功率3.3对5.0(P<；.001)，戒烟难度2.8对4.3(P<；.001)。在吸烟行为方面，在4周时，28.2%(66/234)有1次或1次以上的戒烟尝试(≥1天戒烟)，12周时增加到48.3%(113/234)。治疗4周时，23.1%(54/234)的患者CPD下降50%或以上，12周时降至38.5%(90/234)。12周时，CPD较基线下降41.1%(P<；.001)，第7天和第30天PPA分别为12.0%(28/234)和6.0%(14/234)。在使用体验方面，75.3%(171/227)的人报告传感器增加了他们的戒烟动机。超过90%(>；196/214)的人表示传感器会告诉他们关于CO水平和吸烟行为的信息，73.1%(166/227)的人报告说看到他们的CO值会让他们想要戒烟。Pivot呼吸传感器的使用显著增加了戒烟动机，减少了CPD，并降低了有利的戒烟尝试比率。这些结果增加了戒烟的可能性。因此，结果支持通过个人CO呼气采样的生物反馈在戒烟中的作用。ClinicalTrials.gov NCT04133064；https://clinicaltrials.gov/ct2/show/NCT04133064
Tobacco use is the leading cause of preventable morbidity and mortality. Existing evidence-based treatments are underutilized and have seen little recent innovation. The success of personal biofeedback interventions in other disease states portends a similar opportunity in smoking cessation. The Pivot Breath Sensor is a personal interactive FDA-cleared (over-the-counter) device that measures carbon monoxide (CO) in exhaled breath, enabling users to link their smoking behavior and CO values, and track their progress in reducing or quitting smoking. The objective of this study is to assess the Pivot Breath Sensor in people who smoke cigarettes, evaluating changes in attitudes toward quitting smoking, changes in smoking behavior, and use experience. US adults (18-80 years of age, ≥10 cigarettes per day [CPD]) were recruited online for this remote 12-week study. Participants completed a screening call, informed consent, and baseline questionnaire, and then were mailed their sensor. Participants were asked to submit 4 or more breath samples per day and complete questionnaires at 1-4, 8, and 12 weeks. Outcomes included attitudes toward quitting smoking (Stage of Change, success to quit, and perceived difficulty of quitting), smoking behavior (quit attempts, CPD reduction, and 7-, 30-day point prevalence abstinence [PPA]), and use experience (impact and learning). Participants comprised 234 smokers, mean age 39.9 (SD 11.3) years, 52.6% (123/234) female, mean CPD 20.3 (SD 8.0). The 4- and 12-week questionnaires were completed by 92.3% (216/234) and 91.9% (215/234) of participants, respectively. Concerning attitude outcomes, at baseline, 15.4% (36/234) were seriously thinking of quitting in the next 30 days, increasing to 38.9% (84/216) at 4 weeks and 47.9% (103/215) at 12 weeks (both P<.001). At 12 weeks, motivation to quit was increased in 39.1% (84/215), unchanged in 54.9% (118/215), and decreased in 6.0% (13/215; P<.001). Additional attitudes toward quitting improved from baseline to 12 weeks: success to quit 3.3 versus 5.0 (P<.001) and difficulty of quitting 2.8 versus 4.3 (P<.001). Regarding smoking behavior, at 4 weeks, 28.2% (66/234) had made 1 or more quit attempts (≥1 day of abstinence), increasing to 48.3% (113/234) at 12 weeks. At 4 weeks, 23.1% (54/234) had reduced CPD by 50% or more, increasing to 38.5% (90/234) at 12 weeks. At 12 weeks, CPD decreased by 41.1% from baseline (P<.001), and 7- and 30-day PPA were 12.0% (28/234) and 6.0% (14/234), respectively. Concerning use experience, 75.3% (171/227) reported the sensor increased their motivation to quit. More than 90% (>196/214) indicated the sensor taught them about their CO levels and smoking behavior, and 73.1% (166/227) reported that seeing their CO values made them want to quit smoking. Use of the Pivot Breath Sensor resulted in a significant increase in motivation to quit, a reduction in CPD, and favorable quit attempt rates. These outcomes confer increased likelihood of quitting smoking. Accordingly, the results support a role for biofeedback via personal CO breath sampling in smoking cessation. ClinicalTrials.gov NCT04133064; https://clinicaltrials.gov/ct2/show/NCT04133064
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