Remember elephants and icebergs... 'Your lung function should be here, but it is there!'.

摘要

In the present issue of the European Respiratory Journal, Kotz et al. report on a study aimed at determining the incremental benefit of spirometry in a smoking cessation intervention in individuals with as yet undiagnosed airflow obstruction compatible with mild and moderate chronic obstructive pulmonary disease (COPD). In a randomised clinical trial (RCT) study design, the authors compared an experimental group (nortriptyline and medium-intensity advice with spirometry) with two control groups: CI (nortriptyline and medium-intensity advice without spirometry) and C2 (passive physician advice). The primary end-point was sustained cessation at week 52 with urinary cotinine-validated definitions. Regrettably, the study did not provide evidence that the confrontational approach increases the rate of long-term abstinence from smoking compared with an equally intensive treatment in which smokers were not confronted with spirometry.