To evaluate the effects of smoking intervention in a group of subjects with newly diagnosed airflow limitation (AL).
Of 558 current smokers participating in population spirometric screening for COPD combined with smoking cessation advice, 297 were diagnosed to have AL (FEV1/FVC <0.7). After one year 193 presented for the follow-up visit. Thirty subjects (10.1%) quit smoking. Remaining 163 smokers were invited to the smokers’ clinic. Attendees were randomised to treatment with nicotine patch (n=38) or bupropion SR (n=32). Follow-up was scheduled at 2 weeks (Visit2), end of treatment (Visit3), 6 months (Visit4) and 12 months (Visit5). After 12 months a phone call assessed smoking status. Non-smoking status was validated with carbon monoxide in exhaled air. Patients who did not attend the follow-up visits were considered smokers.
Of 70 smokers with AL attending smokers’ clinic 40 were males and 30 females, mean (SD) age 56 (10) yrs, age at starting smoking 18 (4) yrs, FEV1 73 (17) %pred, Fagerstrom score 6.5 (2.1), exposed to 43 (18) packyrs. Number (%) of smokers attending follow-up were 57 (81%) at Visit2, 34 (49%) at Visit3, 14 (20%) at Visit4 and 69 (99%) after a year (Visit5). The validated quit rate after 12 months was 18.5% (13/70), 25% in the group treated with bupropion SR and 13% in the group treated with nicotine patch (NS).CONCLUSIONS: In smokers with newly diagnosed COPD, who did not quit smoking as the result of minimal intervention, one year validated cessation rate after pharmacological treatment. was 18.5%. The drop-out rate in the follow-up was considerable, necessitating a phone call after one year to assess the smoking status.CLINICAL IMPLICATIONS : In smokers with newly diagnosed COPD a real life smoking interventions result in considerable one year validated quit rate (10.1% after minimal intervention and 18.5% after pharmacological treatment). Every effort should be applied to increase motivation to quit and participation in the programme of smokers with AL.
D.M. Gorecka, None.