Smokers with airway obstruction are more likely to quit smoking

Abstract

Background: Chronic obstructive pulmonary disease (COPD), usually caused by tobacco smoking, is one of the leading causes of morbidity and mortality. Smoking cessation at an early stage of the disease usually stops further progression. A study was undertaken to determine if diagnosis of airway obstruction was associated with subsequent success in smoking cessation, as advised by a physician. Methods: 4494 current smokers (57.4% men) with a history of at least 10 pack-years of smoking were recruited from 100 000 subjects screened by spirometric testing for signs of airway obstruction. At the time of screening all received simple smoking cessation advice. 1177 (26.2%) subjects had airway obstruction and were told that they had COPD and that smoking cessation would halt rapid progression of their lung disease. No pharmacological treatment was proposed. After 1 year all subjects were invited for a follow up visit. Smoking status was assessed by history and validated by exhaled carbon monoxide level. Results: Nearly 70% attended a follow up visit (n = 3077): 61% were men, mean (SD) age was 52 (10) years, mean (SD) tobacco exposure 30 (17) pack-years, and 33.3% had airway obstruction during the baseline examination. The validated smoking cessation rate in those with airway obstruction was 16.3% compared with 12.0% in those with normal spirometric parameters (p = 0.0003). After correction for age, sex, nicotine dependence, number of cigarettes smoked daily, and lung function, success in smoking cessation was predicted by lower lung function, lower nicotine dependence, and lower tobacco exposure. Conclusions: Simple smoking cessation advice combined with spirometric testing resulted in good 1 year cessation rates, especially in subjects with airway obstruction.

Motivating Smokers in the Hospital Pulmonary Function Laboratory to Quit Smoking by Use of the Lung Age Concept

“…Interestingly, these factors might have influenced motivation to quit in opposite ways, the former associated with a higher degree of nicotine dependence and hence less likelihood of quitting and the latter associated with a greater likelihood of quitting (Gorecka et al, 2003). Our data show that patients with higher cigarette consumption but lower lung function were able to significantly reduce their consumption after the visit to the PFT laboratory, suggesting that smokers with impaired lung function may respond better to smoking cessation interventions (Bednarek et al, 2006;Gorecka et al, 2003;McClure et al, 2009). Our study also differed from that of Parkes et al because we examined quit attempts at 1 month, not abstinence rate at 1 year.…”

What mediates the effect of confrontational counselling on smoking cessation in smokers with COPD?

“…If such an effect occurs, the abstinence rates of smokers diagnosed with normal lung function should be very low. In a recent large-scaled prospective study on the association between airway obstruction and smoking cessation in Poland, 12-month abstinence rates from smoking were only slightly lower in subjects with normal lung function (12%) than in subjects with abnormal lung function [50]. To test whether a counterproductive effect occurred in our sample, we randomized another 59 smokers with normal lung function (formally defined as GOLD 0 COPD) to the three intervention groups.…”

Smoking Cessation in Chronic Obstructive Pulmonary Disease

“…17,18 On the other hand, some studies have shown higher !1-year quit rates in smokers with, compared with those without, COPD who were informed of their spirometry results and given brief advice to smoke. 19,20 Moreover, studies of the effectiveness of smoking cessation programs under real-life conditions 21 and in clinical trials of pharmacotherapy combined with either brief or intensive counseling in smokers with COPD 14,15,22 have shown nearly comparable abstinence rates over 1 year compared with quit rates achieved in smokers in general. These findings suggest that smokers with COPD may be equally amenable to smoking intervention strategies as smokers without COPD.…”