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Effectiveness of biomedical risk assessment as an aid for smoking cessation: a systematic review
  1. Raphaël Bize1,
  2. Bernard Burnand2,
  3. Yolanda Mueller2,
  4. Jacques Cornuz1
  1. 1Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland
  2. 2Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
  1. Correspondence to:
 Dr R Bize
 Department of Ambulatory Care and Community Medicine, University of Lausanne, 44 Rue du Bugnon, CH-1011 Lausanne, Switzerland; raphael.bize{at}


Objective: To determine the efficacy of biomedical risk assessment (eg, exhaled carbon monoxide (CO), or genetic susceptibility to lung cancer) as an aid for smoking cessation.

Data sources: Cochrane Tobacco Addiction Group Specialized Register, Cochrane Central Register of Controlled Trials, Medline (1966–2004) and EMBASE (1980–2004).

Study selection: Randomised controlled smoking cessation interventions using biomedical tests with at least 6 months follow-up.

Data extraction: Two reviewers independently screened all search results (titles and abstracts) for possible inclusion. Each reviewer then extracted data from the selected studies, and assessed their methodological quality based on the CONSORT (Consolidated Standards of Reporting Trials) statement criteria.

Data synthesis: Of 4049 retrieved references, eight trials were retained for data extraction and analysis. Three trials isolated the effect of exhaled CO on smoking cessation rates resulting in the following ORs and 95% CIs: 0.73 (0.38 to 1.39), 0.93 (0.62 to 1.41) and 1.18 (0.84 to 1.64). Measurement of exhaled CO and spirometry were used together in three trials, resulting in the following ORs (95% CI): 0.60 (0.25 to 1.46), 2.45 (0.73 to 8.25) and 3.50 (0.88 to 13.92). Spirometry results alone were used in one other trial with an OR (95% CI) of 1.21 (0.60 to 2.42). Ultrasonography of carotid and femoral arteries performed on light smokers gave an OR (95% CI) of 3.15 (1.06 to 9.31).

Conclusions: Scarcity and limited quality of the current evidence does not support the hypothesis that biomedical risk assessment increases smoking cessation as compared with the standard treatment.

  • CO, carbon monoxide

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  • Funding: This study was funded by the Clinical Epidemiology Center (CEPIC), University of Lausanne, Switzerland

  • Competing interests: JC was the coauthor of one of the studies included in the review ( Bovet P, Perret F, Cornuz J, et al. Prev Med2002;:–20.)

  • RB, BB and JC designed the study, reviewed the studies identified and checked the data. YM reviewed the studies identified and checked the data. RB and YM wrote the first draft of the article, and BB and JC provided substantive subsequent contributions. RB is the guarantor.

  • The results of a Cochrane Review can be interpreted differently, depending on people’s perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of review authors, and are not necessarily shared by The Cochrane Collaboration.