BPT with mannitol has a sensitivity and specificity similar to methacholine for the diagnosis of physician-diagnosed asthma in military conscripts but is less costly to perform without the need to use and maintain a nebulizer.

No abstract

Despite medical evaluation and exclusion of asthmatics by a physician during conscription, a high proportion of recruits assigned to work with SCBA smoke, have respiratory symptoms, and have a positive BCTM suggesting current asthma. BCTM has a high sensitivity to predict a significant fall in FEV(1) after exercise with SCBA and participants with a positive BCTM tend to use more health care resources during basic military training. Recruits should be counseled about smoking cessation prior and during basic military training.

Smoking is a major health hazard in young adults. Reducing smoking is the only well established effective primary prevention of chronic obstructive pulmonary disease. We undertook a prospective cross sectional study to determine the prevalence of respiratory symptoms, smoking behaviour and willingness to participate in a smoking cessation program in Swiss conscripts.Methods: Conscripts completed a standardized questionnaire on respiratory symptoms, asthma and smoking behaviour and underwent spirometry measurement.Results: 2604 conscripts were included. 1252 (48%) were current smokers, 144 (6%) were former smokers, 111 (4%) were recent beginners or low intensity smokers and 1097 (42%) were never smokers. Respiratory symptoms were significantly higher in smokers compared to never smokers (wheezing 16% vs. 7%, wheezing without cold 9% vs. 4%, exercise dyspnoea 15% vs. 10%, regular cough 35% vs. 10% and regular phlegm 15% vs. 2%). The mean score of the Fagerstrom Test for Nicotine Dependency (FTND) was 2.6 (± 2.1). According to the transtheoretical model of stage of change 50% were in the precontemplation, 34% in the contemplation, 5% in the preparation, 5% in the action and 6% in the maintenance stage. Amongst the current smokers 33% were willing to participate in a smoking cessation program. Those willing to participate in a smoking cessation program included 17% precontemplators and 53% contemplators.Conclusion: There is a high prevalence of respiratory symptoms in young current smokers. The Fagerstrom Test for Nicotine Dependence score in conscripts is low thus favouring a potentially successful outcome of a smoking cessation intervention. Using motivational stages to tailor smoking cessation aids might preclude adequate interventions in individuals belonging to the precontemplation stage.