Abstract

Background: Health checkup results, even if 12-lead ECG and chest X-ray are included, usually do not reflect risk of smoking and it may lead smokers to continue smoking. Therefore, to show specific risk amount of smoking, 10-year cardiovascular (CV) risks were calculated with and without smoking at the same level of other risk factors and the information was sent to the smokers. Smoking cessation rate was compared between smokers with and without the information. Methods: In subjects who had the annual health checkup offered to adult citizens of Moriguchi city, Osaka, Japan in 2018, the brochure which included the 2 values of 10-year CV risks calculated by the Framingham risk score (2008) based on the results of the health checkup was sent to male smokers aged 40 between 74 with no history of CV disease and the 10-year CV risk between 10% and 40%. Male smokers with the same condition were extracted from subjects who had the annual health checkup in 2017 as the control subjects. Smoking cessation was evaluated at the health checkup next year. Results: The brochure was sent to 499 smokers in 2018 and 344 of those received the health checkup in 2019. The 10-year CV risk of smokers was 1.80±0.05 times higher than that of non-smokers at the same level of other risk factors. As the control subjects, 568 smokers were extracted from 2017 checkup and 407 of those received the health checkup in 2018. Clinical characteristics of the 2018 checkup (n=344) and the 2017 checkup (n=407) groups were similar in terms of age, clinical risk factors, duration of smoking and number of cigarettes smoked per day. Smoking cessation rate of the 2018 checkup group next year was 7.0% while that of the 2017 checkup group was 7.1%. By the logistic regression analysis adjusted for age, duration of smoking and number of cigarettes smoked per day, smoking cessation rate of the 2018 checkup group was not higher than that of the 2017 checkup group (odds ratio=0.97, 95% confidence interval=0.55 to 1.71, p=0.9131). Conclusions: Showing specific amount of risk by smoking was not helpful for smoking cessation. Most smokers seem to be aware of the risk. To promote smoking cessation, interventions such as increased price of cigarette and/or limitation of smoking area may be more practical than emphasizing health hazards of smoking.

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