Smoking cessation in COPD: confronting the challenge

Despite clear evidence of the benefits of smoking cessation in COPD, including decreased disease progression [1, 2], symptom improvement [3] and reduced mortality [4], 30–50% of symptomatic patients with moderate to very severe COPD continue to smoke [5] and, of those who make a serious attempt to q...

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Bibliographic Details
Published in:Internal and emergency medicine 2021-04, Vol.16 (3), p.545-547
Main Author: Tashkin, Donald P.
Format: Article
Language:English
Subjects:
Chronic obstructive pulmonary disease
Cigarette smoking
Cigarettes
Clinical trials
Counseling
Drug addiction
Drug therapy
Emergency medical care
Health Impact of Electronic Cigarettes and Tobacco Heating systems
Im - Commentary
Internal Medicine
Medicine
Medicine & Public Health
Mortality
Nicotine
Patient satisfaction
Quality of life
Respiratory function
Smoking cessation
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Summary:Despite clear evidence of the benefits of smoking cessation in COPD, including decreased disease progression [1, 2], symptom improvement [3] and reduced mortality [4], 30–50% of symptomatic patients with moderate to very severe COPD continue to smoke [5] and, of those who make a serious attempt to quit (counseling plus pharmacotherapy), 65–85% are still smoking at 1 year. For example, the results of randomized controlled trials of approved pharmacotherapy for smoking cessation, along with at least brief counseling, that focused on smokers with COPD, only 14 to approximately 25% succeeded in achieving sustained smoking cessation from 6 to 12 months after randomization [6–9]. Since smokers with COPD are often unable to quit completely as the best strategy for reducing the harmful effects of smoking on COPD progression, reduction in the amount of cigarettes smoked has been considered as a second-best goal with the expectation that a lower number of cigarettes smoked would still be beneficial in reducing the harm from smoking. However, data from the Lung Health Study failed to find a relationship between reduction in cigarettes smoked per day and the annual rate of decline in lung function, except for the small minority of smokers who were able to both reduce their amount of smoking to very low levels and sustain that amount of reduction [10].
ISSN:1828-0447
1970-9366
DOI:10.1007/s11739-021-02710-2