RESEARCH PAPER
Factors associated with current smoking in COPD patients: A cross-sectional study from the Eastern Black Sea region of Turkey
 
More details
Hide details
1
Department of Chest Diseases, School of Medicine, Recep Tayyip Erdoğan Üniversitesi, Rize, Turkey
2
Department of Public Health, School of Medicine, Süleyman Demirel University, Isparta, Turkey
3
Department of Social Services, Faculty of Economics and Administrative Sciences, Mehmet Akif Ersoy University, Burdur, Turkey
4
Department of Psychiatric Nursing, School of Health Science, Çoruh University, Artvin, Turkey
Publish date: 2018-05-22
 
Tob. Induc. Dis. 2018;16(May):22
KEYWORDS:
TOPICS:
ABSTRACT:
Introduction:
Even though smoking is a major reason for the development and progression of chronic obstructive pulmonary disease (COPD)-and quitting smoking is the only way to stop its progression-a significant number of smokers still continue to smoke after being diagnosed with COPD. The aim of this study is to compare the clinical and demographic characteristics of COPD patients who are current and former smokers and to find factors associated with their current smoking status.

Methods:
For this study, data were collected between June 2015 and August 2016; COPD patients who had been regularly visiting Hopa State Hospital’s outpatient clinic over the last year or longer were included. Their demographic, clinical and functional data were recorded. Patients completed a pulmonary function test, six-minute walk test (6-MWT), COPD assessment test (CAT), and modified Medical Research Council (mMRC) dyspnea scale. Comparisons were then made according to their smoking status.

Results:
In total 100 patients were included in the study; with a mean age of 63.4±10.7 years and mostly males (94%). Regarding smoking status, 49% were current smokers and 51% were former smokers. Multivariate logistic regression analysis revealed that current smoking was negatively associated with age (odds ratio, OR=0.93, 95% confidence interval, CI=0.88–0.96) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage (OR=0.32, 95% CI=0.13– 0.79), and was positively associated with six-minute walk distance (OR =1.005, 95% CI=1.001–1.009) and CAT score (OR=1.07, 95% CI=1.009–1.13).

Conclusions:
Nearly half of the COPD patients in the study continued smoking even after having been diagnosed with COPD. The younger patients, with better lung function, better exercise capacity and poor quality of life were associated with current smoking.

CORRESPONDING AUTHOR:
Dilek Karadogan   
Department of Chest Diseases, School of Medicine, Recep Tayyip Erdoğan Üniversitesi, 05000 Rize, Turkey
 
REFERENCES (36):
1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of Chronic Obstructive Pulmonary Disease. Published, 2016. Accessed October 31, 2017.
2. Scanlon PD, Connett JE, Waller LA, et al. Smoking cessation and lung function in mild-to-moderate Chronic Obstructive Pulmonary Disease. The Lung Health Study. Am J Respir Crit Care Med. 2000;161(2 Pt 1):381-390. doi:10.1164/ajrccm.161.2.9901044
3. Shahab L, Jarvis MJ, Britton J, West R. Prevalence, diagnosis and relation to tobacco dependence of chronic obstructive pulmonary disease in a nationally representative population sample. Thorax. 2006;61(12):1043-1047. doi:10.1136/thx.2006.064410
4. Schiller JS, Ni H. Cigarette smoking and smoking cessation among persons with chronic obstructive pulmonary disease. Am J Health Promot. 2006;20(5):319-323. doi:10.4278/0890-1171-20.5.319
5. Schauer GL, Wheaton AG, Malarcher AM, Croft JB. Smoking prevalence and cessation characteristics among U.S. adults with and without COPD: findings from the 2011 Behavioral Risk Factor Surveillance System. COPD. 2014;11(6):697-704. doi:10.3109/15412555.2014.898049
6. Jiménez Ruiz CA, Ramos Pinedo A, Cicero Guerrero A, Mayayo Ulibarri M, Cristobal Fernández M, Lopez Gonzalez G. Characteristics of COPD smokers and effectiveness and safety of smoking cessation medications. Nicotine Tob Res. 2012;14(9):1035-1039. doi:10.1093/ntr/nts001
7. Bednarek M, Gorecka D, Wielgomas J, et al. Smokers with airway obstruction are more likely to quit smoking. Thorax. 2006;61(10):869-873. doi:10.1136/thx.2006.059071
8. Eklund BM, Nilsson S, Hedman L, Lindberg I. Why do smokers diagnosed with COPD not quit smoking? - a qualitative study. Tob Induc Dis. 2012;10(1):17. doi:10.1186/1617-9625-10-17
9. Poureslami I, Shum J, FitzGerald JM. Why do Chinese people with COPD continue smoking: the attitudes and beliefs of Chinese residents of Vancouver, Canada. Diversity and Equality in Health and Care. 2015;12(1):18-27. doi:10.21767/2049-5471.100025
10. Bestall J, Paul E, Garrod R, Garnham R, Jones P, Wedzicha J. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54(7):581-586. doi:10.1136/thx.54.7.581
11. Kupiainen H, Kinnula VL, Lindqvist A, et al. Successful Smoking Cessation in COPD: Association with Comorbidities and Mortality. Pulm Med. 2012;2012:725024. doi:10.1155/2012/725024
12. Cheruvu VK, Odhiambo LA, Mowls DS, Zullo MD, Gudina AT. Health-related quality of life in current smokers with COPD: factors associated with current smoking and new insights into sex differences. Int J Chron Obstruct Pulmon Dis. 2016;11:2211-2219. doi:10.2147/copd.s106207
13. Bestall J, Paul E, Garrod R, Garnham R, Jones P, Wedzicha J. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax. 1999;54(7):581-586. doi:10.1136/thx.54.7.581
14. Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34(3):648-654. doi:10.1183/09031936.00102509
15. Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26:948-968. doi:10.1183/09031936.05.00035205
16. Miller MR, Crapo R, Hankinson J, et al; General considerations for lung function testing. Eur Respir J. 2005;26:153-161. doi:10.1183/09031936.05.00034505
17. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111-117. doi:10.1164/rccm.166/1/111
18. Yorgancıoğlu A, Polatlı M, Aydemir Ö, et al. Reliability and validity of Turkish version of COPD assessment test. Tuberk Toraks. 2012;60(4):314-320. doi:10.5578/tt.4321
19. Definitions of smoking status. http://www.health.govt.nz/our-.... Accessed October 31, 2017.
20. Au DH, Bryson CL, Chien JW, et al. The effects of smoking cessation on the risk of chronic obstructive pulmonary disease exacerbations. J Gen Intern Med. 2009;24(4):457-463. doi: 10.1007/s11606-009-0907-y.
21. Public Health Institution of Turkey. Global Adult Tobacco Survey 2012. http://www.who.int/tobacco/sur.... Published, 2014. Accessed October 31, 2017.
22. Bülbül Y, Öztuna F, Gülsoy A, Özlü T. Chronic Obstructive Pulmonary Disease in Eastern Black Sea Region: Characteristics of the Disease and the Frequency of Influenza-Pneumococcal Vaccination. Turkiye Klinikleri J Med Sci. 2010;30(1):24-29. doi:10.5336/medsci.2008-8763
23. Gunen H, Hacievliyagil SS, Kosar F, et al. Factors affecting survival of hospitalised patients with COPD. Eur Respir J. 2005;26(2):234-241. doi:10.1183/09031936.05.00024804
24. Tashkin DP, Murray RP. Smoking cessation in chronic obstructive pulmonary disease. Respir Med. 2009;103(7):963-974. doi:10.1016/j.rmed.2009.02.013
25. Jiménez-Ruiz CA, Masa F, Miravitlles M, et al. Smoking characteristics: differences in attitudes and dependence between healthy smokers and smokers with COPD. Chest. 2001;119(5):1365-1370. doi:10.1378/chest.119.5.1365
26. Adams SG, Pugh JA, Kazis LE, Lee S, Anzueto A. Characteristics associated with sustained abstinence from smoking among patients with COPD. Am J Med. 2006;119(5):441-447. doi:10.1016/j.amjmed.2005.09.055
27. World Health Organization. Toolkit for delivering the 5A’s and 5R’s brief tobacco interventions in primary care. Geneva, Switzerland: World Health Organization; 2014.
28. McAfee T, Babb S, McNabb S, Fiore MC. Helping smokers quit — opportunities created by the Affordable Care Act. N Engl J Med. 2015;372(1):5-7. doi:10.1056/NEJMp1411437
29. Christenhusz LC, Prenger R, Pieterse ME, Seydel ER, van der Palen J. Cost-effectiveness of an intensive smoking cessation intervention for COPD outpatients. Nicotine Tob Res. 2012;14(6):657-663. doi:10.1093/ntr/ntr263
30. Jiménez-Ruiz CA, Solano-Reina S, Signes-Costa J, et al. Budgetary impact analysis on funding smoking-cessation drugs in patients with COPD in Spain. Int J Chron Obstruct Pulmon Dis. 2015;10:2027-2036. doi:10.2147/COPD.S87597
31. Tashkin DP. Smoking Cessation in Chronic Obstructive Pulmonary Disease. Semin Respir Crit Care Med. 2015;36(4):491-507. doi:10.1055/s-0035-1555610
32. Wilson JS, Elborn JS, Fitzsimons D. 'It's not worth stopping now': why do smokers with chronic obstructive pulmonary disease continue to smoke? A qualitative study. J Clin Nurs. 2011;20(5-6):819-827. doi:10.1111/j.1365-2702.2010.03319.x
33. Postolache P, Nemeş RM, Petrescu O, Merişanu IO. Smoking cessation, pulmonary rehabilitation and quality of life at smokers with COPD. Rev Med Chir Soc Med Nat Iasi. 2015;119(1):77-80.
34. Jimenez-Ruiz CA, Pascual Lledó JF, Cícero Guerrero A, Cristóbal Fernández M, Mayayo Ulibarri M, Villar Laguna C. Analysis of quality of life in patients with Chronic Obstructive Pulmonary Disorder (COPD) who give up smoking. Semergen. 2017:1138-3593(17)30231-9. doi:10.1016/j.semerg.2017.08.003
35. Wilson JS, Elborn JS, Fitzsimons D, McCrum-Gardner E. Do smokers with chronic obstructive pulmonary disease report their smoking status reliably? A comparison of self-report and bio-chemical validation. Int J Nurs Stud. 2011;48(7):856-862. doi:10.1016/j.ijnurstu.2011.01.002
36. Lucke T, Herrera R, Wacker M, et al. Systematic Analysis of Self-Reported Comorbidities in Large Cohort Studies - A Novel Stepwise Approach by Evaluation of Medication. PLoS One. 2016;11(10):e0163408. doi:10.1371/journal.pone.0163408
eISSN:1617-9625