PURPOSE: To evaluate the influence of respiratory symptoms and new abnormalities on pulmonary function tests (PFT) on the rates of smoking cessation in our intensive behavior interventions program (IBI).
METHODS: We retrospectively evaluated consecutive smokers that were offered IBI by a multidisciplinary team combined with free medications. PFT were solicited from all patients with respiratory symptoms. Pearson’s chi-square was used to estimate the influence of detected abnormalities on PFT on the rates of abstinence at 1 and 3-months.
RESULTS: 350 patients were evaluated in 20 months. The FT-score was 0-4 in 26%, 5-7 in 43% and 8-10 in 31%; 262 patients started IBI (88% also used medications) and 92% had at least one respiratory complaint: cough (73%), dyspnea (69%) and wheezing (39%). PFT were performed in 242/350 patients and in 76% of those that initiated IBI, showing: normal results in 44%, small airway disease (FEF25-75% < 70%) in 10%, mild obstructive disease in 25%, moderate in 10%, severe in 2.5%, restrictive disease in 7.5% and mixed disease in 1.5%. Patients with abnormal PFT were older (56 vs. 51 years, p=0.0001), had more time of smoking (41 vs. 35 years, p=0.0001), and higher mean FT-score (6.4 vs. 5.7, p=0.04). Abstinence rate was 57% (150/262) in 1-month, 81% (150/185) in 3-months and 77% (72/94) in 6-months. The finding of obstructive and/or restrictive disease on PFT did not influence the beginning of IBI (47% vs. 54%) or the abstinence rates in 1-month (58% vs. 63%) and in 3-months (79% vs. 81%), p=NS for all.
CONCLUSION: The majority of smokers that sought treatment for nicotine-dependence presented respiratory symptoms and 46% were diagnosed with abnormalities on PFT. Patients receiving IBI with medications achieved high rates of abstinence, including those with obstructive/restrictive abnormalities.
CLINICAL IMPLICATIONS: The screening of smokers with PFT creates an opportunity for early diagnosis and treatment of pulmonary diseases and can stimulate the treatment of nicotine-dependence. IBI with medications is efficacious for smoking cessation even in older patients with new diagnosis of COPD.
DISCLOSURE: Ana Thereza Rocha, Consultant fee, speaker bureau, advisory committee, etc. I am a speaker for Pfizer.; No Product/Research Disclosure Information