SMOKING

Smokers with airway obstruction are more likely to quit smoking

M Bednarek¹, D Gorecka¹, J Wielgomas², M Czajkowska-Malinowska³, J Regula⁴, G Mieszko-Filipczyk⁵, M Jasionowicz⁶, R Bijata-Bronisz⁷, M Lempicka-Jastrzebska⁸, M Czajkowski⁹, G Przybylski¹⁰, J Zielinski¹

¹ 2nd Department of Respiratory Medicine, National Research Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
² Outpatient Chest Clinic, Wloclawek, Poland
³ Outpatient Chest Clinic, Bydgoszcz, Poland
⁴ Outpatient Chest Clinic, Dzialdowo, Poland
⁵ Outpatient Chest Clinic, Bytom, Poland
⁶ Outpatient Chest Clinic, Lublin, Poland
⁷ Outpatient Chest Clinic, Inowroclaw, Poland
⁸ Outpatient Chest Clinic, Warsaw (Ochota), Poland
⁹ Outpatient Chest Clinic, Warsaw (Saska Kepa), Poland
¹⁰ Outpatient Chest Clinic, Swiecie, Poland

Correspondence to:
Professor J Zielinski
National Research Institute of Tuberculosis and Lung Diseases, 2nd Department of Respiratory Medicine, 26 Plocka Street, 01-138 Warsaw, Poland;j.zielinski{at}igichp.edu.pl

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.

Abbreviations: CO, carbon monoxide; COPD, chronic obstructive pulmonary disease; FEV₁, forced expiratory volume in 1 second; FTND, Fagerström test for nicotine dependence; FVC, forced vital capacity

Keywords: lung function testing; counselling; smoking cessation; chronic obstructive pulmonary disease

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