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Carbon monoxide monitoring: guidance on good practice
Sylvia May, Administrator, Smoking Cessation Service Research Network, North Woodchester, UK
Abstract
Carbon monoxide (CO) is a gas found in the exhaled breath of smokers. It is used by stop smoking services for both motivational and verification purposes. Current monitoring guidance states CO readings should be attempted in 85% of cases where a client reports having quit at four weeks. In fact, nationwide this figure was 72% in 2006–7 and verification levels varied significantly between services. Hence the aim of this study was to examine procedures used to obtain CO verification. Five high performing services and six services who performed less well in this regard were selected. Managers of these services were interviewed about their attitudes to and their procedures for CO verification. Findings and recommendations were reported for example:
- CO-verification was more likely to be achieved by
specialist core staff than by intermediate advisors.
- Differences between services in CO-verification rates
appeared to be mainly due to different interpretations
of what was required.
- Clarification of the definition of attempting CO-verification
should be disseminated and the importance of actually
obtaining CO-verification should be emphasised.
- Training of advisors and clinical documentation should
reflect the different functions of CO monitoring and
the importance of CO-verification at four weeks post quit.
Declaration of interest: Sylvia May’s post as SCSRN Administrator is funded by Pfizer Ltd. Andy McEwen has received travel funding, honorariums and consultancy payments from manufacturers of smoking cessation products (Pfizer Ltd, Novartis and GSK Consumer Healthcare Ltd). He also receives payment for providing training to smoking cessation specialists and receives royalties from books on smoking cessation. He is a director of the UK National Smoking Cessation Conference (UKNSCC).
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