Imperial College London

ProfessorNickHopkinson

Faculty of MedicineNational Heart & Lung Institute

Professor of Respiratory Medicine
 
 
 
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Contact

 

n.hopkinson

 
 
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Location

 

Muscle LabSouth BlockRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
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489 results found

Williams P, Cheeseman H, Arnott D, Bunce L, Hopkinson N, Laverty Aet al., 2022, Use of tobacco and e-cigarettes among youth in Great Britain in 2022: analysis of a cross sectional survey, Tobacco Induced Diseases, ISSN: 1617-9625

Journal article

Vrinten C, Parnham JC, Filippidis FT, Hopkinson NS, Laverty AAet al., 2022, Risk factors for adolescent smoking uptake: an analysis of prospective data from the Millennium Cohort Study., Lancet (London, England), Vol: 400 Suppl 1, ISSN: 0140-6736

<h4>Background</h4>Preventing smoking uptake among adolescents is essential to achieve a smoke-free generation. The aim of this study was to assess risk factors for smoking in late adolescence and smoking uptake between early and late adolescence, using data from the Millennium Cohort Study. We also present estimates of numbers of smokers and smoking uptake.<h4>Methods</h4>Adolescents aged 14-17 years were included in the analysis. In separate logistic regression models, we assessed associations between age, sex, ethnicity, household income, country of residence, current smoking of a caregiver, current smoking of peers and use of social media, and regular smoking (defined as smoking at least one cigarette per week) at the age of 17 years and smoking uptake between the ages of 14 and 17 years (defined as being a never-smoker at the age of 14 years and a regular smoker at the age of 17 years). We also estimated numbers of regular smoking and smoking uptake using the Office for National Statistics 2018-19 population estimates.<h4>Findings</h4>Data from 8944 adolescents aged 14-17 years with smoking data available were included, 948 (10·6%) of which were regular tobacco smokers at the age of 17 years. 488 (51·5%) of these 948 started smoking between the ages of 14 years and 17 years. Smoking uptake was more common among adolescents reporting caregiver smoking (162 [13·6%] of 1188 vs 324 [5·0%] of 6538 with non-smoking caregivers; p<0·0001); peers smoking (223 [12·6%] of 1764 vs 229 [4·3%] of 5350 without smoking peers; p<0·0001), and those reporting higher (at least 5 h/weekday) social media use (115 [9·8%] of 1176 vs 120 [4·1%] of 2947 with lower [less than 1 h/weekday] social media use; p=0·0059), among 7786 adolescents who did not smoke at age 14. We estimated that 164 313 (95% CI 146 815-181 811) adolescents were regular smokers by the age of 17 yea

Journal article

Vrinten C, Parnham JC, Filippidis FT, Hopkinson NS, Laverty AAet al., 2022, Risk factors for adolescent smoking uptake: an analysis of prospective data from the Millennium Cohort Study., Lancet, Vol: 400 Suppl 1

BACKGROUND: Preventing smoking uptake among adolescents is essential to achieve a smoke-free generation. The aim of this study was to assess risk factors for smoking in late adolescence and smoking uptake between early and late adolescence, using data from the Millennium Cohort Study. We also present estimates of numbers of smokers and smoking uptake. METHODS: Adolescents aged 14-17 years were included in the analysis. In separate logistic regression models, we assessed associations between age, sex, ethnicity, household income, country of residence, current smoking of a caregiver, current smoking of peers and use of social media, and regular smoking (defined as smoking at least one cigarette per week) at the age of 17 years and smoking uptake between the ages of 14 and 17 years (defined as being a never-smoker at the age of 14 years and a regular smoker at the age of 17 years). We also estimated numbers of regular smoking and smoking uptake using the Office for National Statistics 2018-19 population estimates. FINDINGS: Data from 8944 adolescents aged 14-17 years with smoking data available were included, 948 (10·6%) of which were regular tobacco smokers at the age of 17 years. 488 (51·5%) of these 948 started smoking between the ages of 14 years and 17 years. Smoking uptake was more common among adolescents reporting caregiver smoking (162 [13·6%] of 1188 vs 324 [5·0%] of 6538 with non-smoking caregivers; p<0·0001); peers smoking (223 [12·6%] of 1764 vs 229 [4·3%] of 5350 without smoking peers; p<0·0001), and those reporting higher (at least 5 h/weekday) social media use (115 [9·8%] of 1176 vs 120 [4·1%] of 2947 with lower [less than 1 h/weekday] social media use; p=0·0059), among 7786 adolescents who did not smoke at age 14. We estimated that 164 313 (95% CI 146 815-181 811) adolescents were regular smokers by the age of 17 years, of whom 101 715 (85 994-117 435) took up the habit

Journal article

Hopkinson N, 2022, The health and social care crisis makes tobacco control an imperative, BMJ: British Medical Journal, Vol: 379, Pages: 1-2, ISSN: 0959-535X

Journal article

Patel S, Jones SE, Walsh JA, Barker RE, Polgar O, Maddocks M, Hopkinson NS, Nolan CM, Man WD-Cet al., 2022, The Six-Minute Step Test as an Exercise Outcome in COPD., Ann Am Thorac Soc

Journal article

Mikolaizak AS, Rochester L, Maetzler W, Sharrack B, Demeyer H, Mazzà C, Caulfield B, Garcia-Aymerich J, Vereijken B, Arnera V, Miller R, Piraino P, Ammour N, Gordon MF, Troosters T, Yarnall AJ, Alcock L, Gaßner H, Winkler J, Klucken J, Schlenstedt C, Watz H, Kirsten A-M, Vogiatzis I, Chynkiamis N, Hume E, Megaritis D, Nieuwboer A, Ginis P, Buckley E, Brittain G, Comi G, Leocani L, Helbostad JL, Johnsen LG, Taraldsen K, Blain H, Driss V, Frei A, Puhan MA, Polhemus A, Bosch de Basea M, Gimeno E, Hopkinson NS, Buttery SC, Hausdorff JM, Mirelman A, Evers J, Neatrour I, Singleton D, Schwickert L, Becker C, Jansen C-P, clinical validation study WP4 on behalf of Mobilise-D consortiumet al., 2022, Connecting real-world digital mobility assessment to clinical outcomes for regulatory and clinical endorsement-the Mobilise-D study protocol, PLoS One, Vol: 17, ISSN: 1932-6203

BACKGROUND: The development of optimal strategies to treat impaired mobility related to ageing and chronic disease requires better ways to detect and measure it. Digital health technology, including body worn sensors, has the potential to directly and accurately capture real-world mobility. Mobilise-D consists of 34 partners from 13 countries who are working together to jointly develop and implement a digital mobility assessment solution to demonstrate that real-world digital mobility outcomes have the potential to provide a better, safer, and quicker way to assess, monitor, and predict the efficacy of new interventions on impaired mobility. The overarching objective of the study is to establish the clinical validity of digital outcomes in patient populations impacted by mobility challenges, and to support engagement with regulatory and health technology agencies towards acceptance of digital mobility assessment in regulatory and health technology assessment decisions. METHODS/DESIGN: The Mobilise-D clinical validation study is a longitudinal observational cohort study that will recruit 2400 participants from four clinical cohorts. The populations of the Innovative Medicine Initiative-Joint Undertaking represent neurodegenerative conditions (Parkinson's Disease), respiratory disease (Chronic Obstructive Pulmonary Disease), neuro-inflammatory disorder (Multiple Sclerosis), fall-related injuries, osteoporosis, sarcopenia, and frailty (Proximal Femoral Fracture). In total, 17 clinical sites in ten countries will recruit participants who will be evaluated every six months over a period of two years. A wide range of core and cohort specific outcome measures will be collected, spanning patient-reported, observer-reported, and clinician-reported outcomes as well as performance-based outcomes (physical measures and cognitive/mental measures). Daily-living mobility and physical capacity will be assessed directly using a wearable device. These four clinical cohorts were chose

Journal article

Vrinten C, Parnham J, Hopkinson N, Filippidis F, Laverty Aet al., 2022, Risk factors for adolescent smoking uptake – analysis of prospective data from the UK Millennium Cohort Study, Tobacco Induced Diseases, Vol: 20, Pages: 1-6, ISSN: 1617-9625

Introduction:Most people who smoke initiate smoking in adolescence. Risk factors for smoking are changing over time as demographics shift, and technologies such as social media create new avenues for the tobacco industry to recruit smokers. We assessed risk factors associated with smoking uptake and regular smoking among a representative cohort of UK adolescents.Methods:Data come from 8944 children followed prospectively as part of the UK Millennium Cohort Study. Smoking uptake was assessed as adolescents who had never smoked tobacco at the age of 14 years, but reported smoking ≥1 cigarette per week by the age of 17 years (regular smoking). We used logistic regression to assess associations between smoking uptake and selected sociodemographic factors including household income, caregiver smoking, peer smoking, and social media use. Weighted percentages and Office for National Statistics Data were used to estimate numbers of regular smokers and new smokers in the UK.Results:Among the whole sample, 10.6% of adolescents were regular smokers at the age of 17 years. Of these, 52% initiated smoking between the ages of 14 and 17 years. Uptake was more common if caregivers smoked (13.6% vs 5.0%, p<0.001) or friends smoked (12.6% vs 4.3%, p<0.001), and among those reporting >5 hours/ day of social media use (9.8% vs 4.1%, p=0.006). Applying these percentages to population data, an estimated 160000 adolescents in the UK were regular smokers by the age of 17 years, of whom more than 100000 initiated smoking between the ages of 14 and 17 years.Conclusions:This analysis of smoking uptake and regular smoking highlight that smoking behavior remains highly transmissible within families and peer groups, reinforcing inequalities. Social media are highlighted as a potential vector.

Journal article

Jeyin N, Desai SR, Padley SPG, Wechalekar K, Gregg S, Sousa T, Shah PL, Allinson JP, Hopkinson NS, Begum S, Jordan S, Kemp SV, Ridge CAet al., 2022, Dual-energy computed tomographic pulmonary angiography accurately estimates lobar perfusion before lung volume reduction for severe emphysema., Journal of Thoracic Imaging, ISSN: 0883-5993

PURPOSE: To assess if dual-energy computed tomographic pulmonary angiography (DECTPA) derived lobar iodine quantification can provide an accurate estimate of lobar perfusion in patients with severe emphysema, and offer an adjunct to single-photon emission CT perfusion scintigraphy (SPECT-PS) in assessing suitability for lung volume reduction (LVR). MATERIALS AND METHODS: Patients with severe emphysema (forced expiratory volume in 1 s <49% predicted) undergoing evaluation for LVR between May 2018 and April 2020 imaged with both SPECT-PS and DECTPA were included in this retrospective study. DECTPA perfused blood volume maps were automatically segmented and lobar iodine mass was estimated and compared with lobar technetium (Tc99m) distribution acquired with SPECT-PS. Pearson correlation and Bland-Altman analysis were used for intermodality comparison between DECTPA and SPECT-PS. Univariate and adjusted multivariate linear regression were modelled to ascertain the effect sizes of possible confounders of disease severity, sex, age, and body mass index on the relationship between lobar iodine and Tc99m values. Effective radiation dose and adverse reactions were recorded. RESULTS: In all, 123 patients (64.5±8.8 y, 71 men; mean predicted forced expiratory volume in 1 s 32.1 ±12.7%,) were eligible for inclusion. There was a linear relationship between lobar perfusion values acquired using DECTPA and SPECT-PS with statistical significance (P<0.001). Lobar relative perfusion values acquired using DECTPA and SPECT-PS had a consistent relationship both by linear regression and Bland-Altman analysis (mean bias, -0.01, mean r2 0.64; P<0.0001). Individual lobar comparisons demonstrated moderate correlation (r=0.79, 0.78, 0.84, 0.78, 0.8 for the right upper, middle, lower, left upper, and lower lobes, respectively, P<0.0001). The relationship between lobar iodine and Tc99m values was not significantly altered after controlling for conf

Journal article

Pavitt M, Lewis A, Buttery S, Fernandez BO, Mikus-Lelinska M, Banya W, Feelisch M, Polkey M, Hopkinson Net al., 2022, Dietary nitrate supplementation to enhance exercise capacity in hypoxic COPD: EDEN-OX a double-blind, placebo-controlled, randomised crossover study, Thorax, Vol: 77, Pages: 968-975, ISSN: 0040-6376

Rationale: Dietary nitrate supplementation improves skeletal muscle oxygen utilisation and vascular endothelial function. We hypothesised that these effects might be sufficient to improve exercise performance in patients with COPD and hypoxia severe enough to require supplemental oxygen.Methods: We conducted a single-centre, double-blind, placebo-controlled, cross-over study, enrolling adults with COPD who were established users of long-term oxygen therapy. Participants performed an endurance shuttle walk test, using their prescribed oxygen, 3 hours after consuming either 140 mL of nitrate-rich beetroot juice (BRJ) (12.9 mmol nitrate) or placebo (nitrate-depleted BRJ). Treatment order was allocated (1:1) by computer-generated block randomisation.Measurements: The primary outcome was endurance shuttle walk test time. The secondary outcomes included area under the curve to isotime for fingertip oxygen saturation and heart rate parameters during the test, blood pressure, and endothelial function assessed using flow-mediated dilatation. Plasma nitrate and nitrite levels as well as FENO were also measured.Main results: 20 participants were recruited and all completed the study. Nitrate-rich BRJ supplementation prolonged exercise endurance time in all participants as compared with placebo: median (IQR) 194.6 (147.5–411.7) s vs 159.1 (121.9–298.5) s, estimated treatment effect 62 (33–106) s (p<0.0001). Supplementation also improved endothelial function: NR-BRJ group +4.1% (−1.1% to 14.8%) vs placebo BRJ group −5.0% (−10.6% to –0.6%) (p=0.0003).Conclusion: Acute dietary nitrate supplementation increases exercise endurance in patients with COPD who require supplemental oxygen.

Journal article

Philip KEJ, Owles H, McVey S, Pagnuco T, Bruce K, Brunjes H, Banya W, Mollica J, Lound A, Zumpe S, Abrahams AM, Padmanaban V, Hardy TH, Lewis A, Lalvani A, Elkin S, Hopkinson NSet al., 2022, An online breathing and wellbeing programme (ENO Breathe) for people with persistent symptoms following COVID-19: a parallel-group, single-blind, randomised controlled trial, The Lancet Respiratory Medicine, Vol: 10, Pages: 851-862, ISSN: 2213-2600

BACKGROUND: There are few evidence-based interventions for long COVID; however, holistic approaches supporting recovery are advocated. We assessed whether an online breathing and wellbeing programme improves health related quality-of-life (HRQoL) in people with persisting breathlessness following COVID-19. METHODS: We conducted a parallel-group, single-blind, randomised controlled trial in patients who had been referred from one of 51 UK-based collaborating long COVID clinics. Eligible participants were aged 18 years or older; were recovering from COVID-19 with ongoing breathlessness, with or without anxiety, at least 4 weeks after symptom onset; had internet access with an appropriate device; and were deemed clinically suitable for participation by one of the collaborating COVID-19 clinics. Following clinical assessment, potential participants were given a unique online portal code. Participants were randomly assigned (1:1) to either immediate participation in the English National Opera (ENO) Breathe programme or to usual care. Randomisation was done by the research team using computer-generated block randomisation lists, with block size 10. The researcher responsible for randomisation was masked to responses. Participants in the ENO Breathe group participated in a 6-week online breathing and wellbeing programme, developed for people with long COVID experiencing breathlessness, focusing on breathing retraining using singing techniques. Those in the deferred group received usual care until they exited the trial. The primary outcome, assessed in the intention-to-treat population, was change in HRQoL, assessed using the RAND 36-item short form survey instrument mental health composite (MHC) and physical health composite (PHC) scores. Secondary outcome measures were the chronic obstructive pulmonary disease assessment test score, visual analogue scales (VAS) for breathlessness, and scores on the dyspnoea-12, the generalised anxiety disorder 7-item scale, and the short

Journal article

Buttery S, Philip K, Alghamdi S, Williams P, Quint J, Hopkinson Net al., 2022, Reporting of data on participant ethnicity and socioeconomic status in high-impact medical journals: A targeted literature review, BMJ Open, Vol: 12, ISSN: 2044-6055

Objectives: To assess the frequency of reporting of ethnicity (or ‘race’) and socioeconomic status (SES) indicators in high-impact journals.Design: Targeted literature reviewData sources: The 10 highest ranked general medical journals using Google scholar h5 index.Eligibility criteria: Inclusion criteria were, human research, reporting participant level data. Exclusion criteria were non-research article, animal/other non-human participant/subject; or no participant characteristics reported.Data extraction and synthesis: Working backwards from 19/04/2021 in each journal, two independent reviewers selected the 10 most recent articles meeting inclusion/exclusion criteria, to create a sample of 100 articles.Data on the frequency of reporting of ethnicity (or ‘race’) and SES indicators were extracted and presented using descriptive statistics.Results: Of one hundred research articles included, 35 reported ethnicity and 13 SES. By contrast, 99 reported age, and 97 reported sex or gender. Among the articles not reporting ethnicity only 3 (5%) highlighted this as a limitation, and only 6 (7%) where SES data were missing. Median number of articles reporting ethnicity per journal was 2.5/10 (range 0 to 9). Only 2 journals explicitly requested reporting of ethnicity (or race), and 1 requested SES. Conclusions: The majority of research published in high-impact medical journals does not include data on the ethnicity and socioeconomic status of participants, and this omission is rarely acknowledged as a limitation. This situation persists despite the well-established importance of this issue and ICMJE recommendations to include relevant demographic variables to ensure representative samples. Standardized explicit minimum standards are required.Strengths and Limitations of this study - This study included recent studies from a range of the highest impact general medical journals.- Different inclusion/exclusion criteria for articles could be justifiably use

Journal article

Holt H, Talaei M, Greenig M, Zenner D, Symons J, Relton C, Young KS, Davies MR, Thompson KN, Ashman J, Rajpoot SS, Kayyale AA, El Rifai S, Lloyd PJ, Jolliffe DA, Timmis O, Finer S, Ilidriomiti S, Miners A, Hopkinson NS, Alam B, Lloyd-Jones G, Dietrich T, Chapple I, Pfeffer PE, McCoy D, Davies GA, Lyons RA, Griffiths CJ, Kee F, Sheikh A, Breen G, Shaheen SO, Martineau ARet al., 2022, Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK), Thorax, Vol: 77, Pages: 900-912, ISSN: 0040-6376

Background Risk factors for severe COVID-19 include older age, male sex, obesity, black or Asian ethnicity and underlying medical conditions. Whether these factors also influence susceptibility to developing COVID-19 is uncertain.Methods We undertook a prospective, population-based cohort study (COVIDENCE UK) from 1 May 2020 to 5 February 2021. Baseline information on potential risk factors was captured by an online questionnaire. Monthly follow-up questionnaires captured incident COVID-19. We used logistic regression models to estimate multivariable-adjusted ORs (aORs) for associations between potential risk factors and odds of COVID-19.Results We recorded 446 incident cases of COVID-19 in 15 227 participants (2.9%). Increased odds of developing COVID-19 were independently associated with Asian/Asian British versus white ethnicity (aOR 2.28, 95% CI 1.33 to 3.91), household overcrowding (aOR per additional 0.5 people/bedroom 1.26, 1.11 to 1.43), any versus no visits to/from other households in previous week (aOR 1.31, 1.06 to 1.62), number of visits to indoor public places (aOR per extra visit per week 1.05, 1.02 to 1.09), frontline occupation excluding health/social care versus no frontline occupation (aOR 1.49, 1.12 to 1.98) and raised body mass index (BMI) (aOR 1.50 (1.19 to 1.89) for BMI 25.0–30.0 kg/m2 and 1.39 (1.06 to 1.84) for BMI >30.0 kg/m2 versus BMI <25.0 kg/m2). Atopic disease was independently associated with decreased odds (aOR 0.75, 0.59 to 0.97). No independent associations were seen for age, sex, other medical conditions, diet or micronutrient supplement use.Conclusions After rigorous adjustment for factors influencing exposure to SARS-CoV-2, Asian/Asian British ethnicity and raised BMI were associated with increased odds of developing COVID-19, while atopic disease was associated with decreased odds.Trial registration number ClinicalTrials.gov Registry (NCT04330599).

Journal article

Williams PJ, Cheeseman H, Arnott D, Bunce L, Hopkinson NS, Laverty Aet al., 2022, Use of tobacco and e-cigarettes among youth in Great Britain in 2022: analysis of a cross-sectional survey, Publisher: Cold Spring Harbor Laboratory

INTRODUCTION Although e-cigarettes can be an effective form of nicotine substitution for adults attempting to quit smoking, their use among children and young people is a concern. Accurate data about this are needed to inform debates over policy and regulation in the UK and elsewhere.METHODS Using data from an online survey of 2,613 people aged 11 to 18 years, conducted by the market research company YouGov in March 2022, we present prevalence estimates of e-cigarette and tobacco use.We use logistic regression models to assess differences in e-cigarette use, tobacco use and use of disposable e-cigarettes across a range of covariates including age, sex, tobacco smoking status, social class and country.RESULTS Among the 18.0% of those surveyed who reported ever having smoked a cigarette, 83.9% were not regular (at least once per week) smokers and 16.1% were (15.1% and 2.9% of the total sample respectively). Among the 19.2% of those surveyed who had ever used an e-cigarette, 79.2% were not regular users, while 20.8% were (15.2% and 4.0% respectively. Regular e-cigarette use was more common than regular tobacco smoking (4.0% vs 2.9%). E-cigarette use was more common among those who also smoked tobacco, with 9.0% of never e-cigarette users ever smoking tobacco, compared with 89.4% of regular e-cigarette users. Both smoking and e-cigarette use were associated with increasing age and use by others within the home, but not with social class. Use of disposable e-cigarettes was reported by 53.8% of those who have ever used an e-cigarette, and more common among girls than boys.DISCUSSION Regular e-cigarette use is now more common than smoking in children and youth, though the majority of this is among those who have also smoked tobacco. Measures to reduce the appeal of e-both e-cigarettes and tobacco to children and young people are warranted.

Working paper

Hopkinson N, Polkey M, Alghamdi S, Alsulayyim A, Philip K, Buttery Set al., 2022, Oscillatory Positive Expiratory Pressure Therapy in COPD (O-COPD): a randomised controlled trial, Thorax, ISSN: 0040-6376

Background: Oscillatory Positive Expiratory Pressure (OPEP) devices are intended to facilitate sputum clearance and reduce cough, but there is limited evidence for their effectiveness in COPD, or to guide patient selection. We aimed to assess the impact of OPEP therapy on quality of life and objective measures of cough and sleep disturbance in COPD patients with regular sputum production.Methods: We enrolled stable COPD patients, who reported sputum production every day or most days, into an assessor-blind, parallel group, randomised controlled trial comparing three months of using an Acapella device against usual care (including use of the active cycle of breathing technique (ACBT)). The primary outcome was cough-related quality of life measured using the Leicester Cough Questionnaire (LCQ). Secondary outcomes included fatigue (FACIT score) and generic quality of life(EQ-5D). In a sub study(n=45), objective monitoring of cough and disturbance/movement during sleep were also available.Results: 122 participants (61/61 OPEP/control) were recruited, 40% female, 17% smokers, FEV1 38(25-56)% predicted, and age 62±10 years. 103 completed the study (55/48 OPEP/control). Use of OPEP was associated with an improvement in LCQ compared to controls; MD [95% CI] +1.03[0.71 to 2.10]; (p=0.03), FACIT score +4.68[1.34 to 8.02];(p<0.001) and EQ-5D +4.00[0.49 to 19.75];(p=0.04). There was also an improvement in cough frequency -60[-43 to -95] coughs/24 hours (P<0.001), but no statistically significant effect on sleep disturbance was identified.Conclusions: Regular use of an Acapella device improves symptoms and quality of life in people with COPD who produce sputum daily or most days.

Journal article

Williams PJ, Philip KEJ, Gill NK, Flannery D, Buttery S, Bartlett EC, Devaraj A, Kemp SV, Addis J, Derbyshire J, Chen M, Morris K, Laverty AA, Hopkinson NSet al., 2022, Immediate, remote smoking cessation intervention in participants undergoing a targeted lung health check: quit smoking lung health intervention trial, a randomized controlled trial, Chest, ISSN: 0012-3692

BACKGROUND: Lung cancer screening programs provide an opportunity to support people who smoke to quit, but the most appropriate model for delivery remains to be determined. Immediate face-to-face smoking cessation support for people undergoing screening can increase quit rates, but it is not known whether remote delivery of immediate smoking cessation counselling and pharmacotherapy in this context also is effective. RESEARCH QUESTION: Does an immediate telephone smoking cessation intervention increase quit rates compared with usual care among a population enrolled in a targeted lung health check (TLHC)? STUDY DESIGN AND METHODS: In a single-masked randomized controlled trial, people 55 to 75 years of age who smoke and attended a TLHC were allocated by day of attendance to receive either immediate telephone smoking cessation intervention (TSI) support (starting immediately and lasting for 6 weeks) with appropriate pharmacotherapy or usual care (UC; very brief advice to quit and signposting to smoking cessation services). The primary outcome was self-reported 7-day point prevalence smoking abstinence at 3 months. Differences between groups were assessed using logistic regression. RESULTS: Three hundred fifteen people taking part in the screening program who reported current smoking with a mean ± SD age of 63 ± 5.4 years, 48% of whom were women, were randomized to TSI (n = 152) or UC (n = 163). The two groups were well matched at baseline. Self-reported quit rates were higher in the intervention arm, 21.1% vs 8.9% (OR, 2.83; 95% CI, 1.44-5.61; P = .002). Controlling for participant demographics, neither baseline smoking characteristics nor the discovery of abnormalities on low-dose CT imaging modified the effect of the intervention. INTERPRETATION: Immediate provision of an intensive telephone-based smoking cessation intervention, delivered within a targeted lung screening context, is associated with incr

Journal article

Edwards R, Hopkinson N, 2022, The Khan review: the UK Government must act now for a smokefree future, The Lancet, Vol: 400, Pages: 979-981, ISSN: 0140-6736

Journal article

Williams P, Cumella A, Philip K, Laverty A, Nicholas Het al., 2022, Smoking and socio-economic factors linked to acute exacerbations of COPD: analysis from an Asthma + Lung UK survey, BMJ Open Respiratory Research, Vol: 9, ISSN: 2052-4439

Background: Understanding the factors driving acute exacerbations of COPD is key to reducing their impact on human health and wellbeing. Methods: 5997 patients, mean 66 years, 64% female, completed an online survey between December 2020 and May 2021 about living with COPD developed by the charity Asthma+Lung UK.Results: The 3731(62.2%) survey participants reporting frequent(>2/year) exacerbations were more likely to smoke (AOR 1.70, 95%CI 1.470-1.98), have lower annual household income (<£20,000, (AOR: 1.72, 1.36-2.17), live in a cold and damp home (AOR: 1.78, 1.50-2.11), and report previous occupational exposure to dust, fumes, and chemicals. Smokers were more likely to report attending hospital to manage their most recent AECOPD compared to ex-smokers (AOR: 1.25, 95% CI 0.99- 1.59).

Journal article

Hopkinson N, 2022, Vectura and Philip Morris – the leopard hasn’t changed its spots., Thorax, Vol: 77, ISSN: 0040-6376

The uniquely lethal nature of the tobacco industry’s products, the industry’s environmental impact and its incompatibility with human rights make the takeover of Vectura, a pharmaceutical company focused on inhaler technology, by tobacco giant Philip Morris International (PMI), extremely unwelcome. The idea that a company which, based on its market share and the global death toll, kills more than a million people every year4 should be allowed to expand into the delivery of healthcare has been widely condemned, including by the British Thoracic Society, the European Respiratory Society and the US COPD Foundation, as well as the American Lung Association and American Thoracic Society who referred to the move as “reprehensible”.

Journal article

Alghamdi SM, Alasmari AM, Alsulayyim AS, Philip KE, Birring SS, Polkey MI, Hopkinson NSet al., 2022, Impact of Oscillatory Positive Expiratory Pressure (OPEP) Therapy on Objectively Determined Cough and Sleep Disturbance in COPD: A Sub-Study from the O-COPD Trial, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

Conference paper

Alghamdi SM, Alasmari AM, Alsulayyim AS, Philip KE, Buttery SC, Williams P, Orton C, Birring SS, Polkey MI, Hopkinson NSet al., 2022, Oscillatory Positive Expiratory Pressure (OPEP) Therapy in Chronic Obstructive Pulmonary Disease (COPD): The O-COPD Trial, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

Conference paper

Soriano JB, Hopkinson NS, 2022, Sing out for COPD!, EUROPEAN RESPIRATORY JOURNAL, Vol: 59, ISSN: 0903-1936

Journal article

Hopkinson NS, 2022, COPD, smoking, and social justice, The Lancet Respiratory Medicine, Vol: 10, Pages: 428-430, ISSN: 2213-2600

Journal article

Alghamdi SM, Philip KE, Alsulayyim AS, Alasmari AM, Buttery SC, Birring SS, Polkey MI, Hopkinson NSet al., 2022, Cough Frequency in Chronic Obstructive Pulmonary Disease (COPD) with Frequent Sputum Production, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

Conference paper

Casaburi R, Merrill DD, Harding G, Leidy NK, Rossiter HB, Tal-Singer R, Hamilton A, CBQC Constant Work Rate Exercise Working Groupet al., 2022, A Conceptual Framework for Use of Increased Endurance Time During Constant Work Rate Cycle Ergometry as a Patient-Focused Meaningful Outcome in COPD Clinical Trials., Chronic Obstr Pulm Dis, Vol: 9, Pages: 252-265, ISSN: 2372-952X

The Chronic Lung Disease Biomarker and Clinical Outcome Assessment Qualification Consortium (CBQC) evaluates the potential of biomarkers and outcome measures as drug development tools. Exercise endurance is an objective indicator of treatment benefit, closely related to daily physical function. Therefore, it is an ideal candidate for an outcome for drug development trials. Unfortunately, no exercise endurance measure is qualified by regulatory authorities for use in trials of chronic obstructive pulmonary disease (COPD) and no approved COPD therapies have claims of improving exercise endurance. Consequently, it has been challenging for developers to consider this outcome when designing clinical trials for new therapies. Endurance time during constant work rate cycle ergometry (CWRCE), performed on an electronically braked stationary cycle ergometer, provides an exercise endurance measure under standardized conditions. Baseline individualized work rate for each participant is set using an incremental test. During CWRCE the patient is encouraged to continue exercising for as long as possible. Although not required, physiological and sensory responses (e.g., pulmonary ventilation, heart rate, dyspnea ratings) are frequently collected to support interpretation of endurance time changes. Exercise tolerance limit is reached when the individual is limited by symptoms, unable to maintain pedaling cadence or unable to continue safely. At exercise cessation, exercise duration is recorded. An CWRCE endurance time increase from the pre-treatment baseline is proposed as a key efficacy endpoint in clinical trials. In COPD, improved exercise endurance has a direct relationship to the experience of physical functioning in daily life, which is a patient-centered, meaningful benefit.

Journal article

Williams PJ, Cumella A, Philip KEJ, Laverty AA, Hopkinson NSet al., 2022, Smoking and socio-economic factors linked to acute exacerbations of COPD: analysis from an Asthma + Lung UK survey, Publisher: Cold Spring Harbor Laboratory

<jats:title>ABSTRACT</jats:title><jats:p>Understanding the factors driving acute exacerbations of COPD is key to reducing their impact on human health and wellbeing. 5997 patients, mean 66 years, 64% female, completed an online survey between December 2020 and May 2021 about living with COPD developed by the charity Asthma+Lung UK. The 3731(62.2%) reporting frequent(≥2/year) exacerbations were more likely to smoke (AOR 1.70, 95%CI 1.470-1.98), have lower annual household income (≤£20,000, (AOR: 1.72, 1.36-2.17), live in a cold and damp home (AOR: 1.78, 1.50-2.11), and report previous occupational exposure to dust, fumes, and chemicals. Strategies to improve COPD outcomes must address issues of social justice.</jats:p>

Working paper

Williams PJ, Philip KEJ, Gill NK, Flannery D, Buttery S, Bartlett EC, Devaraj A, Kemp SV, Addis J, Derbyshire J, Chen M, Morris K, Laverty AA, Hopkinson NSet al., 2022, Immediate, remote smoking cessation intervention in participants undergoing a targeted lung health check: QuLIT2 a randomised controlled trial, Publisher: Cold Spring Harbor Laboratory

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Lung cancer screening programs provide an opportunity to support smokers to quit, but the most appropriate model for delivery remains to be determined. Immediate face to face smoking cessation support for people undergoing screening can increase quit rates, but it is not known whether remote delivery of immediate smoking cessation counselling and pharmacotherapy in this context is also effective.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>In a single-blind randomised controlled trial, smokers aged 55-75 years attending a Targeted Lung Health Check (TLHC) were allocated by day of attendance to receive either immediate telephone smoking cessation support (TSI) (starting immediately and lasting for 6 weeks) with appropriate pharmacotherapy, or usual care (very brief advice to quit and signposting to smoking cessation services) (UC). The primary outcome was self-reported 7-day point prevalence smoking abstinence at three months. Differences between groups were assessed using logistic regression.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>315 current smokers taking part in the screening programme, mean (SD) age 63(5.4) years, 48% female, were randomised to telephone smoking cessation (n=152) or usual care (n=163). The two groups were well-matched at baseline. Self-reported quit rates were higher in the intervention arm, 21.1% vs 8.9% (odds ratio [OR]: 2.83, 95% CI 1.44-5.61, p=0.002). Controlling for participant demographics, baseline smoking characteristics or the discovery of abnormalities on low dose CT scanning did not modify the effect of the intervention.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Immediate provision of an intensive telephone-bas

Working paper

Hopkinson NS, 2022, Medicinal licensing of e-cigarettes, The Lancet, Vol: 399, Pages: 1602-1603, ISSN: 0140-6736

Journal article

Philip K, Owles H, McVey S, Pagnuco T, Bruce K, Harry B, Banya W, Mollica J, Lound A, Zumpe S, Abrahams A, Padmanaban V, Hardy T, Lewis A, Lalvani A, Elkin S, Hopkinson Net al., 2022, Impact of an online breathing and wellbeing programme (ENO Breathe) in people with persistent symptoms following COVID-19: a randomised controlled trial, The Lancet Respiratory Medicine, ISSN: 2213-2600

BackgroundEvidence-based interventions for Long COVID are lacking, however holistic approaches supporting recovery are advocated. We assessed whether an online breathing and wellbeing programme (ENO Breathe) improves health related quality-of-life (HRQoL) in people with persisting breathlessness following COVID-19.MethodsWe conducted a parallel-group, single-blind, randomised-controlled trial, involving 51 UK-based Long COVID clinics. Following clinical assessment, potential participants were given a unique online portal code. Those used were randomly allocated to immediate, or deferred (controls), ENO Breathe participation - a 6-week online breathing and wellbeing programme, developed for people with Long COVID, focusing on breathing re-training utilising singing techniques. FindingsThere were 150 participants (mean(SD) 49(12)years, 81% female, 320(127) days since symptom onset; ENO Breathe (n=74), Control (n=76). The primary outcome was change in Health-Related Quality of Life (HRQoL) from baseline to end of the 6-week course, assessed using the RAND SF-36 Mental (MHC) and Physical (PHC) Health Composite Scores. Compared to controls, ENO Breathe was associated with an improvement in MHC of 2·42 points (95%CI 0·03 to 4·80, p=0·047), but not PHC 0·6 (-1·33 to 2·52 points, p=0·54). The secondary outcome measure Visual Analogue Scale (VAS) for breathlessness (running) also favoured ENO Breathe participation -10·48, (-17·23 to -3·73, p=0·003). No other statistically significant between group differences in secondary outcomes were observed. Thematic analysis of ENO Breathe participant experience, using focus groups and free-text responses identified three key themes: 1) improvements in symptoms; 2) feeling that the programme was complementary to standard care; 3) the particular suitability of singing and music to address their needs.InterpretationAn online breathing and wellbeing program

Journal article

Hopkinson N, 2022, Philip Morris and Vectura- an invasive growth, Tobacco Control, Vol: 31, Pages: 127-127, ISSN: 0964-4563

Journal article

Philip K, Bu F, Polkey M, Brown J, Steptoe A, Hopkinson N, Fancourt Det al., 2022, Relationship of smoking with current and future social isolation and loneliness: 12-year follow-up of older adults in England, The Lancet Regional Health Europe, Vol: 14, ISSN: 2666-7762

BackgroundSmoking is often colloquially considered “social”. However, the actual relationship of smoking with current and future social isolation and loneliness is unclear. We therefore examined these relationships over a 12-year follow-up.MethodsIn this cohort study, we used a nationally representative sample of community dwelling adults aged 50 years and over from the English Longitudinal Study of Ageing (N=8780) (45% male, mean(SD) age 67(10) years. We examined associations of self-reported smoking status at baseline assessment, with social isolation (low social contact, social disengagement, domestic isolation), and loneliness (3-item UCLA loneliness scale), measured at baseline, and follow-up at 4, 8 and 12 years, using ordinary least squares regression models.FindingsAt baseline, smokers were more likely to be lonely (coef.=0·111, 95% CI 0·025 – 0·196) and socially isolated than non-smokers, having less frequent social interactions with family and friends (coef.= 0·297, 95%CI 0·148 – 0·446), less frequent engagement with community and cultural activities (coef.= 0·534, 95%CI 0·421 – 0·654), and being more likely to live alone (Odds Ratio =1·400, 95%CI 1·209 – 1·618). Smoking at baseline was associated with larger reductions in social contact (coef.=0·205, 95%CI 0·053 – 0·356, to 0·297, 95%CI 0·140 – 0·455), increases in social disengagement (coef.=0·168, 95%CI 0·066 – 0·270, to coef.=0·197, 95%CI 0·087 – 0·307), and increases in loneliness (coef.=0·105, 95%CI 0·003 – 0·207), at 4-year follow-up) over time. No association was found between smoking and changes in cohabitation status. Findings were independent of all identified confounders, including age, sex, social class and the presence of physical and mental

Journal article

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