The inclusion of smokers in pulmonary rehabilitation (PR) is often debated. However, the role of PR as an aid to smoking cessation has been much less considered. The objective of this preliminary retrospective study was to compare smoking cessation rates between patients with chronic obstructive pulmonary disease (COPD) who completed a PR program and those who received usual care.
Data were obtained from the pulmonary function lab database at Hôpital du Sacré-Coeur de Montréal (HSCM). Inclusion criteria were: 1) evidence of COPD according to GOLD standards (FEV1/FVC < 0.7); 2) two or more pulmonary function test results with carboxyhemoblogin (HbCO) measurements; and 3) an initial HbCO ≥ 2% suggesting an active smoking status. The sample was divided into two subgroups: those who completed a structured PR program at HSCM (PR group) and those who did not (non-PR group). The proportion of subjects with an HbCO < 2% at the last follow-up was compared between the two subgroups with a Mann-Whitney test. The number of subjects with two or more consecutive final HbCO measurements < 2% was compared with a student t test.
Overall, 413 subjects were included in the study: 27 subjects in the PR group and 386 in the non-PR group. After a follow-up of 31 ± 24 months, 81.5% of subjects from the PR group versus 46.1% from the non-PR group (p < 0.01) had a final HbCO value < 2%, suggesting at least short-term abstinence from smoking. Additionally, 37% of subjects in the PR group, compared to 8% in the non-PR group (p < 0.05), had two or more consecutive final HbCO measurements < 2%, suggesting sustained quitting.
The present findings suggest that patients who participate in a structured PR program achieve higher abstinence rates than those who receive usual care.
Results from this preliminary study suggest that PR may play a role as an aid to smoking cessation in COPD patients. Future well-designed intervention studies are needed to confirm these findings.
Emilie Chan-Thim, Grant monies (from sources other than industry) V. Pepin is a research scholar of the Fonds de la recherche en santé du Quebec (FRSQ) for the 2007–2011 period. She received a one-year operating grant from the Canadian Lung Association for the 2007–2008 period for a pilot project entitled “Optimization of pulmonary rehabilitation”. She also obtained a 3-year operating grant from the FRSQ for the 2007–2010 period to pursue the same project.; Consultant fee, speaker bureau, advisory committee, etc. In the past 12 months, S. Parenteau received honoraries for speaking at conferences sponsored by GlaxoSmithKline, Pfizer, and AstraZeneca. A. Desjardins is part of the advisory board for Pfizer and has received honoraries for speaking at conferences sponsored by Pfizer.; No Product/Research Disclosure Information