Characteristics of COPD Smokers and Effectiveness and Safety of Smoking Cessation Medications

Ruiz, Carlos A. Jiménez; Pinedo, Angela Ramos; Guerrero, Ana Cicero; Ulibarri, Marisa Mayayo; Fernández, Mercedes; Gonzalez, Gema Lopez

doi:10.1093/ntr/nts001

Cited by 37 publications

(23 citation statements)

References 12 publications

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“…Even severe COPD smokers (stages III and IV) can have the same abstinence rates as smokers at the earlier stages of the disease (I and II) and as the control group of smokers, if they can follow an intensive supportive program. Our results are relevant to those referred by Jimenez-Ruiz et al [31] as far as the effectiveness and safety of drug treatment for smoking cessation in smokers with severe and very severe COPD with high continuous abstinence rates (48.5%) in 24 weeks after the quit date.…”

Section: Discussionsupporting

confidence: 81%

Smoking cessation effectiveness in smokers with COPD and asthma under real life conditions

Gratziou

Florou

Ischaki

et al. 2014

Respiratory Medicine

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Section: Discussionsupporting

confidence: 81%

Smoking cessation effectiveness in smokers with COPD and asthma under real life conditions

Gratziou

Florou

Ischaki

et al. 2014

Respiratory Medicine

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“…Subsequent studies, in both clinical (e.g., Rennard et al, 2011;Nides et al, 2006;Aubin et al, 2008) and real-world settings (e.g., Boudrez, Gratziou, Messig & Metcalfe, 2011;Heydari, Talischi, Tafti & Masjedi, 2012;Jimenez et al, 2012), have confirmed the drug's efficacy at aiding cessation. Enthusiasm for the drug, however, has been somewhat dampened by concerns about its safety: specifically, since its launch, varenicline has been associated with a number of serious adverse psychological experiences.…”

Section: Introductionmentioning

confidence: 98%

Physician and Pharmacist Care of Varenicline Users in a Real-World Setting

Frandsen

Ferguson

2013

J. Smok Cessat

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S ince its launch as a smoking cessation aid, varenicline use has been linked to a number of serious adverse events, notably the exacerbation of pre-existing psychiatric illness, depressed mood and suicidal ideation. Regulators' fears have been somewhat allayed by varenicline's status as a prescription only medication. The purpose of this study was to examine the care provided by physicians -or general practitioners -and pharmacists to varenicline users under real-world conditions. Participants were 141 patients who had filled a prescription for varenicline at a participating pharmacy within the previous six-months. Identified patients were mailed a survey to complete that included items on interactions with their physician and pharmacy staff, and knowledge of treatment side-effects. Most participants reported that their physician encouraged them to set a quit date (82.5%) and provided additional cessation materials (57.2%). While most (79.0%) physicians discussed whether varenicline was appropriate for the patient, fewer asked about psychiatric illness (40.1%), or asked to be informed about mood or behaviour change during treatment (48.1%). Participants (78.4%) reported that their physician had discussed a follow-up consultation, but only 59.4% of patients who had finished treatment at the time of the survey reported having one. Most reported discussing potential drug side-effects with their physician (71.0%) and or pharmacist (52.9%); when probed, knowledge was variable. These results suggest that many patients do not receive the level of support that physicians and pharmacists are assumed to provide.

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“…While one study using computed tomography (CT) imaging found that FTND score was inversely correlated with CT-defined emphysema and COPD severity, the authors conceded that these findings may be largely due to selection bias and other biological processes which may lead to increased lung density in smokers [ 29 ]. Smokers with COPD have higher FTND scores, which reflects greater dependency on nicotine, compared to both smokers without COPD [ 8 ] and to individuals who quit smoking after COPD diagnosis [ 28 , 30 ]. Higher FTND scores were also associated with emergency-room admission for smoking-related conditions, compared to admission for other conditions [ 31 ], and with more negative symptoms among smokers engaged in cessation efforts [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, some highly addicted smokers with the shortest TTFC would have been excluded, biasing findings toward the null. Conversely, individuals who persist in smoking following a diagnosis of COPD are likely more addicted compared to individuals who quit post-diagnosis [ 19 , 30 ]; current smokers who report COPD at the follow-up questionnaire may be enriched with individuals with shorter TTFC, and we may therefore overestimate the association between TTFC and COPD. These two biases are in opposite directions and the overall effect is likely to be of small magnitude; our risk estimates should approximate the true association.…”

Section: Discussionmentioning

confidence: 99%

Time to First Morning Cigarette and Risk of Chronic Obstructive Pulmonary Disease: Smokers in the PLCO Cancer Screening Trial

Guertin

Wacholder

et al. 2015

PLoS ONE

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BackgroundTime to first cigarette (TTFC) after waking is an indicator of nicotine dependence. The association between TTFC and chronic obstructive pulmonary disease (COPD), the third leading cause of death in the United States, has not yet been reported.MethodsWe investigated the cross-sectional association between TTFC and prevalent COPD among 6,108 current smokers in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. COPD was defined as a self-reported diagnosis of emphysema, chronic bronchitis, or both. Current smokers in PLCO reported TTFC, the amount of time they typically waited before smoking their first cigarette of the day after waking, in four categories: ≤5, 6-30, 31-60, or >60 minutes. We used logistic regression models to investigate the association between TTFC and prevalent COPD with adjustments for age, gender, race, education, and smoking (cigarettes/day, years smoked during lifetime, pack-years, age at smoking initiation), and prior lung cancer diagnosis.ResultsCOPD was reported by 19% of these 6,108 smokers. Individuals with the shortest TTFC had the greatest risk of COPD; compared to those with the longest TTFC (>60 minutes) the adjusted odds ratios (OR) and 95% confidence intervals (CI) for COPD were 1.48 (95% CI, 1.15-1.91), 1.64 (95% CI, 1.29-2.08), 2.18 (95% CI, 1.65-2.87) for those with TTFC 31-60 minutes, 6-30 minutes, and ≤5 minutes, respectively (P-trend <0.0001). The association between TTFC and emphysema was similar to that for bronchitis, albeit the ORs were slightly stronger for chronic bronchitis; comparing TTFC ≤5 minutes to >60 minutes, the adjusted OR (95% CI) was 2.29 (1.69-3.12) for emphysema and 2.99 (1.95-4.59) for chronic bronchitis.ConclusionsCurrent smokers with shorter TTFC have increased risk of COPD compared to those with longer TTFC, even after comprehensive adjustment for established smoking covariates. Future epidemiologic studies, including prospective designs, should incorporate TTFC to better assess disease risk and evaluate the potential utility of TTFC as a COPD screening tool for smokers in the clinical setting.

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Characteristics of COPD Smokers and Effectiveness and Safety of Smoking Cessation Medications

Cited by 37 publications

References 12 publications

Smoking cessation effectiveness in smokers with COPD and asthma under real life conditions

Smoking cessation effectiveness in smokers with COPD and asthma under real life conditions

Physician and Pharmacist Care of Varenicline Users in a Real-World Setting

Time to First Morning Cigarette and Risk of Chronic Obstructive Pulmonary Disease: Smokers in the PLCO Cancer Screening Trial

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