Measuring Exhaled Carbon Monoxide Can Rapidly Increase Confidence to Quit Cigarette Smoking

Background: Confidence to quit cigarette smoking has been shown to predict quit attempts and abstinence regardless of level of motivation, but limited evidence exists on enhancing smokers’ confidence level Objective: This study assessed the impact of exhaled carbon monoxide (eCO) measurement on adult cigarette smokers’ confidence and motivation to quit (n = 22) and explored predictors of confidence and motivation. Methods: Level of confidence and motivation was measured verbally using a 0-10 scale immediately before and after eCO measurement, and smoking history information was collected using a written survey. Results: Post-eCO confidence level was significantly higher vs pre-eCO (7.09 vs 5.55, 27.7% increase; p = 0.004, d = 0.50), and non-significant post-eCO increase in motivation was found (8.41 vs 7.64, 10.1% increase; p = 0.070, d = 0.31). Baseline confidence level had a significant moderately negative association with pack-year smoking history, and baseline motivation level had a significant strongly negative association with pack-year smoking history, current average number of cigarettes smoked per day, and baseline eCO value. Conclusion: In the current study, measuring eCO intrinsically led to a significant increase in adult cigarette smokers’ confidence to quit and a non-significant increase in their motivation to quit. Thus, measuring eCO may help facilitate quit attempts and abstinence in community-dwelling adult cigarette smokers by rapidly increasing their confidence to quit. Keywords: Cigarette; Tobacco; Carbon Monoxide; Smoking; Cessation; Confidence; Motivation