Smokers with airway obstruction are more likely to quit smoking

Michal Bednarek ¹, Dorota Gorecka ¹, Jacek Wielgomas ², Malgorzata Czajkowska-Malinowska ³, Janusz Regula ⁴, Gabriela Mieszko-Filipczyk ⁵, Maria Jasionowicz ⁶, Renata Bijata-Bronisz ⁷, Maria Lempicka-Jastrzebska ⁸, Marek Czajkowski ⁹, Grzegorz Przybylski ¹⁰ and Jan Zielinski ^1*

¹ National Research Institute of Tuberculosis and Lung Diseases, 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

^* To whom correspondence should be addressed. E-mail: j.zielinski{at}igichp.edu.pl.

Accepted 6 June 2006

Abstract

Background and aim: 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 of the disease. Our aim was to determine if diagnosis of airway obstruction (AO) was associated with subsequent success in smoking cessation, as advised by a physician.

Methods: 4494 current smokers (57.4% males) with a history of at least 10 pack-years of smoking were recruited from 110,000 subjects screened by spirometry for signs of AO. At the time of screening, all received simple anti-smoking advice. 1,177 (26.2%) subjects had AO 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 one 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=3,077): 61% were men, mean age was 52±10 years, mean tobacco exposure was 30±17 pack-years, and 33.3% had AO during the baseline exam. The validated quit rate in those with AO was 16.3%, compared to 12.0% in those with normal spirometry (p=0.0003). After correction for age, gender, nicotine dependence, number of cigarettes smoked daily and lung function success in quitting smoking was predicted by lower lung function, lower nicotine dependence, and lower tobacco exposure.

Conclusions: Simple anti-smoking advice combined with spirometry test resulted in good one-year cessation rates, especially in subjects with AO.

Keywords: COPD, anti-smoking advice, smoking cessation, spirometry

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