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.

Changes in smoking prevalence and cessation support, and factors associated with successful smoking cessation in Swedish patients with asthma and COPD

“…The increased smoking prevalence among men below age 65 years with COPD is interesting because it is not consistent with previous studies where patients with COPD were more likely to cease smoking compared with smokers in the general population [30,31]. The general prevalence of mild COPD at younger ages may have increased during the last decade due to higher awareness of the need to perform spirometry, and in this group of patients the rate of smoking cessation is lower [32].…”

Patient-centred assessment of COPD in primary care: experience from a cross-sectional study of health-related quality of life in Europe

“…25 For mild patients who remain undiagnosed, some argue that early detection and prevention -particularly in introducing smoking cessation programmes -may offer a better long-term prognosis 26,27 although other studies have not confirmed this. 28,29 Also, although only five European countries were represented in this analysis and there were some inter-country variations in demographic factors, the relationship between HRQL impairment and PCP-rated severity showed very similar patterns across countries, suggesting that these data may be representative at the European level. This requires confirmation in further studies, with representation in Northern and Eastern Europe.…”

COPD prevalence is increased in lung cancer, independent of age, sex and smoking history

“…This argues strongly for the routine use of spirometry in smokers to identify those with COPD and those with a significantly elevated risk for lung cancer, both of which have previously been shown to assist in smoking cessation [30][31][32].…”

“…We believe that, just as it is important to measure and document blood pressure (for risk of future stroke), bone mineral density (for risk of future fractures) or BMI (for risk of future diabetes), lung function should be measured and recorded for assessing the risk of future lung cancer [10,[13][14][15]34]. The assessment of lung cancer risk and the utility of measuring lung function have potential clinical benefits in smoking cessation [30][31][32] and targeted CT screening [35]. There may also be utility in the early diagnosis of lung cancer where delays in the diagnosis [16], tumour size and mortality are closely related [36].…”