Smoking Prevalence and Cessation Characteristics among U.S. Adults With and Without COPD: Findings from the 2011 Behavioral Risk Factor Surveillance System

Schauer, Gillian L.; Wheaton, Anne G.; Malarcher, Ann; Croft, Janet B.

doi:10.3109/15412555.2014.898049

Cited by 31 publications

(28 citation statements)

References 15 publications

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“…Recent studies performed in the USA found smoking rates between 35% and 45% among adult patients with COPD 28,29. In our series, the prevalence of active smokers is 55%, contrasting with reports recently published in Spain that set it at about 25% 22,23.…”

Section: Discussioncontrasting

confidence: 99%

Active smoking and COPD phenotype: distribution and impact on prognostic factors

Riesco¹,

Alcázar²,

Trigueros³

et al. 2017

COPD

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PurposeSmoking can affect both the phenotypic expression of COPD and factors such as disease severity, quality of life, and comorbidities. Our objective was to evaluate if the impact of active smoking on these factors varies according to the disease phenotype.Patients and methodsThis was a Spanish, observational, cross-sectional, multicenter study of patients with a diagnosis of COPD. Smoking rates were described among four different phenotypes (non-exacerbators, asthma-COPD overlap syndrome [ACOS], exacerbators with emphysema, and exacerbators with chronic bronchitis), and correlated with disease severity (body mass index, obstruction, dyspnea and exacerbations [BODEx] index and dyspnea grade), quality of life according to the COPD assessment test (CAT), and presence of comorbidities, according to phenotypic expression.ResultsIn total, 1,610 patients were recruited, of whom 46.70% were classified as non-exacerbators, 14.53% as ACOS, 16.37% as exacerbators with emphysema, and 22.40% as exacerbators with chronic bronchitis. Smokers were predominant in the latter 2 groups (58.91% and 57.67%, respectively, P=0.03). Active smoking was significantly associated with better quality of life and a higher dyspnea grade, although differences were observed depending on clinical phenotype.ConclusionActive smoking is more common among exacerbator phenotypes and appears to affect quality of life and dyspnea grade differently, depending on the clinical expression of the disease.

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Section: Discussioncontrasting

confidence: 99%

Active smoking and COPD phenotype: distribution and impact on prognostic factors

Riesco¹,

Alcázar²,

Trigueros³

et al. 2017

COPD

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“…Given a shared risk factor (which accounts for up to 25% of all strokes and is found in twice as many COPD vs non-COPD patients) (6, 7) smoking, it stands to reason that both stroke and COPD would co-exist in certain individuals. However, the rate of COPD among stroke patients has not previously been reported.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and influence of chronic obstructive pulmonary disease on stroke outcomes in hospitalized stroke patients

Lekoubou

Ovbiagele

2017

eNeurologicalSci

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BACKGROUND Chronic obstructive pulmonary disease (COPD) and stroke are important causes of death. COPD patients are at higher risk of cerebral hypoxia and aspiration. Yet, relatively little is known about the prevalence of COPD among stroke patients or its impact on outcomes after an index stroke. We assess the prevalence of COPD among hospitalized stroke patients in a nationally representative sample and examine the effect of COPD with mortality risk in the hospital after a stroke. METHODS Using the National Inpatient Sample, a nationally representative dataset of US hospital admissions between January 2004 and December 2009 (n=48,087,002), we assessed Crude and age-adjusted COPD prevalence among stroke patients and in-hospital mortality rates by COPD status. Independent associations of COPD with in-hospital mortality following stroke were evaluated using multivariable logistic regression. RESULTS 11.71% (95% CI: 11.48–11.94%) of all adult patients hospitalized for stroke had COPD. The crude and age-adjusted in-hospital mortality rates for these patients were 6.33% (95% CI: 6.14–6.53%) and 5.99% (95% CI: 4.05–7.94%), respectively. On multivariable analyses, COPD was modestly associated with overall stroke mortality (OR 1.03; 95% CI 1.01–1.06; p=0.018). The greater risks of mortality were seen among those with intracerebral hemorrhage (OR: 1.12; 95% CI 1.03–1.20; p=0.005) and ischemic stroke patients (OR 1.08; 95% CI 1.03–1.13, p=0.001). CONCLUSIONS 12% of hospitalized stroke patients have COPD. The presence of COPD is independently associated with higher odds of dying during stroke. Prospective studies are needed to identify any modifiable risk factors contributing to this deleterious relationship.

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“…1 Among patients with diagnosed COPD in the United States, the prevalence of current smoking was higher than that among adults without COPD or other chronic diseases (47.3 vs. 20.0%, respectively). 2 Interestingly, despite this difference in smoking prevalence, motivation to quit smoking does not differ between smokers with COPD and without COPD, 3 and current smokers with COPD were just as likely as smokers without chronic diseases to make a pastyear quit attempt (59.7 vs. 53.9%, respectively) and even more likely to avail themselves of smoking cessation resources, such as a telephone quitline or pharmacotherapy (p < 0.001). 2 Those who eventually succeed in quitting and remaining abstinent often do so only after multiple attempts.…”

Section: Smoking Cessationmentioning

confidence: 91%

Smoking Cessation in Chronic Obstructive Pulmonary Disease

Tashkin

2015

Semin Respir Crit Care Med

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Smoking cessation is the most effective strategy for slowing down the progression of chronic obstructive pulmonary disease (COPD) and reducing mortality in the approximately 50% of patients with diagnosed COPD who continue to smoke. While behavioral interventions (including simple advice) have modest efficacy in improving smoking quit rates, the combination of counseling and pharmacotherapy is more effective than either alone. When combined with even brief counseling, nicotine replacement therapy (NRT), bupropion SR, and varenicline have all been shown to be effective in promoting smoking cessation and sustained abstinence in smokers with COPD to a degree comparable to that observed in the general smoking population. However, the recidivism rate is high after initial quitting so that at the end of 1 year, approximately 80% or more of patients are still smoking. Thus, new approaches to smoking cessation are needed. One approach is to combine different pharmacotherapies, for example, nicotine patch plus rapidly acting NRT (e.g., gum or nasal spray) and/or bupropion or even varenicline plus either NRT or bupropion, in a stepwise approach over a varying duration depending on the severity of nicotine dependence and nicotine withdrawal symptoms during the quit attempt, as proposed in the American College of Chest Physicians Tobacco Dependence Took Kit. Electronic (e)-cigarettes, which deliver vaporized nicotine without most of the noxious components in the smoke from burning tobacco cigarettes, also has potential efficacy as a smoking cessation aid, but their efficacy and safety as either substitutes for regular cigarettes or smoking cessation aids require additional study. This task is complicated because e-cigarettes are currently unregulated and hundreds of different brands are currently available.

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Smoking Prevalence and Cessation Characteristics among U.S. Adults With and Without COPD: Findings from the 2011 Behavioral Risk Factor Surveillance System

Abstract: Adults with COPD were just as likely as those without COPD to make a past-year quit attempt; however, approximately 40% of smokers with COPD did not try to quit.

Cited by 31 publications

References 15 publications

Active smoking and COPD phenotype: distribution and impact on prognostic factors

Active smoking and COPD phenotype: distribution and impact on prognostic factors

Prevalence and influence of chronic obstructive pulmonary disease on stroke outcomes in hospitalized stroke patients

Smoking Cessation in Chronic Obstructive Pulmonary Disease

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