Evidence map›Paper›PMID 33592559›Full record

SynthesisDrug and alcohol dependence2021

Cessation classification likelihood increases with higher expired-air carbon monoxide cutoffs: a meta-analysis.

Joshua L Karelitz, Erin A McClure, Caitlin Wolford-Clevenger, Lauren R Pacek, Karen L Cropsey

Abstract readMeta-AnalysisReview
In one paragraph

Synthesis in Drug and alcohol dependence, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Randomized Controlled Trial of Aerobic Exercise for Smoking Cessation Among Individuals With Elevated Depressive Symptoms.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024
    Trial
  5. Trial
  6. Article
  7. Article
  8. Vaping Dose, Device Type, and E-Liquid Flavor are Determinants of DNA Damage in Electronic Cigarette Users.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023
    Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Joshua L KarelitzDivision of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, 5150 Centre Ave, Suite 4C, Pittsburgh, PA, 15232, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 5150 Centre Ave, Suite 4C, Pittsburgh, PA, 15232, USA. Electronic address: karelitzjl@upmc.edu.
Erin A McClureDepartment of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, 67 President St, MSC 861, Charleston, SC, 29425, USA; Hollings Cancer Center, Medical University of South Carolina, 67 President St, MSC 861, Charleston, SC, 29425, USA.
Caitlin Wolford-ClevengerDepartment of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, 1670 University Blvd Birmingham, AL, 35233, USA.
Lauren R PacekDepartment of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2068 Erwin Road, Room 3038, Durham, NC, 27705, USA.
Karen L CropseyDepartment of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, 1670 University Blvd Birmingham, AL, 35233, USA.

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI KENNETH H MAYER · 2004 to 2026
$94.4M
Determining the impact of cannabis use and severity on tobacco cessation outcomes: A prospective tobacco treatment trialR37CA237245 · NCI · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI MCCLURE, ERIN A · 2019 to 2025
$4.2M
Integration of Evidence-based Alcohol Interventions into HIV CareU01AA020802 · NIAAA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CROPSEY, KAREN L, MUGAVERO, MICHAEL J · 2011 to 2020
$4.2M
Effectiveness of a smoking cessation algorithm integrated into HIV primary careR01DA044112 · NIDA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CRANE, HEIDI M., CROPSEY, KAREN L · 2018 to 2022
$3.5M
Circadian and sleep mechanisms among racial groups for nicotine dependence, craving, and withdrawalR01DA046096 · NIDA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CROPSEY, KAREN L, GAMBLE, KAREN L · 2020 to 2024
$2.8M
Translational Research Training in Cancer Prevention and ControlT32CA186873 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Kathryn H. Schmitz, Jian-Min Yuan · 2014 to 2026
$2.7M
In Vivo Experience with NRT to Increase Adherence and Smoking AbstinenceR01DA039678 · NIDA · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CROPSEY, KAREN L · 2016 to 2020
$2.6M
Mobile health interventions for varenicline adherence among HIV-positive smokersK01DA043413 · NIDA · DUKE UNIVERSITY · PI PACEK, LAUREN RENEE · 2017 to 2021
$860k
NCI NIH HHS R37 CA237245NCI NIH HHS T32 CA186873NIAAA NIH HHS U01 AA020802NIAID NIH HHS P30 AI060354NIDA NIH HHS K01 DA043413NIDA NIH HHS R01 DA039678NIDA NIH HHS R01 DA044112NIDA NIH HHS R01 DA046096
6 · The paper itself

Abstract

backgroundExpired-air carbon monoxide (CO) is commonly used to biochemically verify smoking status. The CO cutoff and CO monitor brand may affect the probability of classifying smokers as abstinent, thus influencing conclusions about the efficacy of cessation trials. No systematic reviews have tested this hypothesis. Therefore, we performed a meta-analysis examining whether the likelihood of smoking cessation classification varied due to CO cutoff and monitor brand.

methodsEligible studies (k = 122) longitudinally assessed CO-verified cessation in adult smokers in randomized trials. Primary meta-regressions separately assessed differences in quit classification likelihood due to continuous and categorical CO cutoffs (Low, 3-4 parts per million [ppm]; [SRNT] Recommended, 5-6 ppm; Moderate, 7-8 ppm; and High, 9-10 ppm); exploratory analyses compared likelihood outcomes between monitor brands: Bedfont and Vitalograph.

resultsThe likelihood of quit classification increased 18% with each 1 ppm increase above the lowest cutoff (3 ppm). Odds of classification as quit significantly increased between each cutoff category and High: 261% increase from Low; 162% increase from Recommended; and 150% increase from Moderate. There were no differences in cessation classification between monitor brands.

conclusionsAs expected, higher CO cutoffs were associated with greater likelihood of cessation classification. The lack of CO monitor brand differences may have been due to model-level variance not able to be followed up in the present dataset. Researchers are advised to report outcomes using a range of cutoffs-including the recommended range (5-6 ppm)-and the CO monitor brand/model used. Using higher CO cutoffs significantly increases likelihood of quit classification, possibly artificially elevating treatment strategies.

Indexed as

Smoking CessationAdultCarbon MonoxideHumansMaleProbabilitySmokersSmokingCarbon MonoxideBioverificationExpired-air carbon monoxideMeta-analysisSmoking cessation

Identifiers

PMID33592559
PMCPMC8026538

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.