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"Fantastic Voyage" Approach May Deter Smoking
What the Study Showed
Most people are familiar with the damage that smoking does to the lungs, but many don't realize that the noxious chemicals in smoke also harm the heart, brain, and other areas. In this study, researchers at the University Institute of Social and Preventive Medicine in Switzerland took simple sound-wave images of the arteries of long-term smokers and then showed and explained the images to them. In many cases, the vessels were visibly clogged by plaque, a sticky substance that tends to build up and lead to heart attacks, strokes, impotence, and other problems. The frightening personal photos spurred many of the smokers to quit. The study appeared in the February 2002 issue of Preventive Medicine.

How It Was Done
The trial involved 153 smokers from the Seychelles, a group of islands off the coast of eastern Africa. Despite limited exposure to tobacco advertising, at least 40% of the male residents and 10% of the female residents smoke.

Half the study participants underwent ultrasonography, a safe, painless, and noninvasive procedure that uses sound waves to take pictures of the inside of the body. (The same technique is used in pregnant women to take snapshots of a growing fetus.) Researchers took images of the main arteries in the neck and the thigh. The remaining participants did not get an ultrasound. All the participants, however, were counseled by their doctors to stop smoking.

The doctors then reviewed the ultrasound results one-on-one with the individual smokers, indicating areas where sticky plaque was gumming up and hardening their arteries and putting them at high risk for heart attacks and strokes. Most took a genuine interest in their imaging study.

Six months later, the researchers conducted follow-up telephone interviews with the participants. Nearly 22% of those who had viewed a photo of their own arteries had stopped smoking, compared with only 6% who had not had an imaging study done. Unfortunately, the ultrasound images did not spur those who got a clean health report to quit; only 5% of those with ultrasounds showing no signs of (visible) plaque development reported having quit.

Why It's Important
The easy-to-visualize, personalized ultrasound images used in this study appear to be a relatively simple, economical, yet highly effective way of encouraging smokers to quit. Bringing health implications down from a hypothetical hazard to an in-the-flesh reality appeared to be a strong motivator for behavior change. Similar benefits have been noted this past year in Canada, where graphic images of diseased lungs and organs are now mandatory on cigarette packaging, and overall smoking rates have subsequently dropped.

This type of approach could have implications for other hard-to-break habits as well. Sending someone home with such a photo to hang on their refrigerator could, for example, prove to be effective in spurring them to eat better. Given the strategy's simplicity and the potential huge benefits, further study is certainly warranted.

Source: Bovet P, Perret F, Cornuz J, Quilindo J, Paccaud F. Improved smoking cessation in smokers given ultrasound photographs of their own atherosclerotic plaques. Preventive Medicine 2002;34:215-220.


Date Published: 03/08/2003
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