Smoking cessation affects the natural history of COPD

Abstract

BackgroundCigarette smoking is the most commonly encountered and readily identifiable risk factor for COPD. However, it is not clear which quantitative factors related to smoking influence the prognosis of COPD patients.MethodsA total of 204 patients with a long-term history of smoking were enrolled into this study and followed up for 5 years. Patients were divided into “death” or “survival” groups based on follow-up results and “quitting-smoking” or “continuing-smoking” groups based on whether they gave up smoking.ResultsPatients in the death group had a longer smoking time, lower prevalence of quitting smoking, later onset of COPD symptoms, older age at quitting smoking, lower forced expiratory volume in one second (FEV1) % predicted, and lower ratio of FEV1/forced vital capacity. Age, age at quitting smoking, and FEV1% predicted were independently associated with mortality from COPD. Compared to the continuing-smoking group, the quitting-smoking group had a lower mortality rate, longer course of COPD, earlier onset of COPD symptoms, and lower residual volume percent predicted. During the 5-year follow-up, 113 deaths were recorded (quitting-smoking group: n=92; 40 deaths; continuing-smoking group: n=112; 73 deaths). The mortality risk remained significantly higher in the continuing-smoking group than the quitting-smoking group (log-rank test, 13.59; P=0.0002).ConclusionSmoking time may be related to the mortality rate from COPD. Smoking cessation has the greatest capacity to influence the natural history of COPD.

Predicting the outcomes and costs for a cohort of 426 patients with Chronic Obstructive Pulmonary Disease (COPD) in Bulgaria through a Markov model

“…The results from our current model were interesting and present a hypothetical view of how the next 10 years would unfold for the patient, for whom we had only one year of observation. Despite the short follow-up period, our results are consistent with documented literature on how smoking affects the natural progression of COPD (Bai et al 2017) and serve as a validation to the model. The implication from these results for Bulgaria would lead us to believe that a national smoking cessation programme should be implemented, as well as encouraging patients to seek professional help at earlier stages, since Gold A patients have the best disease control of non-smokers and tend to live longer.…”

Socio-demographic factors of COPD mortality in India

“…13 Among different factors, duration of smoking seems to be an important one. 14 Quitting smoking helps in prolonging survival, as evident from previous researches, probably by relieving emphysema. 14,15 As India documented a reduction in smoking prevalence from 34.6% to 28.6% among citizen aged 15 years and older, it is expected to reduce the burden of COPD in future.…”

“…14 Quitting smoking helps in prolonging survival, as evident from previous researches, probably by relieving emphysema. 14,15 As India documented a reduction in smoking prevalence from 34.6% to 28.6% among citizen aged 15 years and older, it is expected to reduce the burden of COPD in future. 6 Since SHS increased the risk of COPD mortality, the benefit of smoking reduction could be multifold.…”

Forced oscillation technique for early detection of the effects of smoking and COPD: contribution of fractional-order modeling

“…There is a consensus in literature about the great importance of early COPD diagnosis, enabling the establishment of measures that may alter the course of the disease, including pharmacological and non-pharmacological interventions and smoking cessation. 7 – 11 Assessment of respiratory obstruction in the early stages is critically dependent on the sensitivity of pulmonary function tests. 12 It has previously been observed that spirometric indices are not sensitive to small changes due to smoking.…”