PURPOSE: Tobacco has been advocated as the main cause of COPD. Smoking cessation is the only effective treatment in reducing the accelerated decline in FEV1. The aim of this study was to analyze long term abstinence rates and lung function decline in COPD patients.
METHODS: A group of 62 patients, treated in our Tobacco Clinic 5 years ago, were contacted by phone or by mail and another appointment was offered. A standardized medical questionnaire including nicotine dependence issues was administered. Self reported smoking status was validated by exhaled carbon monoxide (CO). Spirometry and radiography of the chest were performed in all patients. Quantitative data were described using mean (SD) values. Unpaired and paired t tests were used to compare groups and differences in FEV1.
RESULTS: Eight patients died (age 63.6±7.9) in the initial group (3 cancer, 1 COPD exacerbation and 4 without data). Only 23 patients of the remaining 54 came to the Clinic and they were classified as current smokers (group A) or ex-smokers (group B). Those who did not attend the appointment were considered smokers for the final analysis. There were no differences at baseline visit (5 years ago) between A and B, regarding age, number of cigarettes, Fägerstrom test, Richmond test, BMI and treatment for nicotine dependence (NRT, multicomponent psychological program or bupropion); but differences were found in pulmonary function test, being B more severe than A, (FEV1%: 51±12 v 75±20, p<0.001). Abstinence rate was 14% (8/54) at 5 years. Spirometric values showed a decrease in both groups but only significant in current smokers. Group A; FVC%: 81±15 v 75±19, p<0.001; FEV1%: 75±20 v 62±17, p<0.001. Group B; FVC%: 77±11 v 76±11, p=0.4; FEV1%: 51±12 v 48±16, p<0.1.
CONCLUSION: We conclude that COPD patients show low abstinence rate at 5 years. Those who keep smoking suffer a 13% decrease in FEV1 for only a 3% in quitters.
CLINICAL IMPLICATIONS: Tobacco quitting in COPD patients is paramount to avoid the decline in pulmonary function.
DISCLOSURE: Jaime Signes-Costa, No Financial Disclosure Information; No Product/Research Disclosure Information