Low nicotine dependence and high self-efficacy can predict smoking cessation independent of the presence of chronic obstructive pulmonary disease: a three year follow up of a population-based study
More details
Hide details
Department of Public Health and Clinical Medicine, Division of Medicine, the OLIN unit, Umeå University, Umeå, Sweden
Department of Research, Norrbotten County Council, Luleå, Sweden
Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, the OLIN Unit, Umeå University, Umeå, Sweden
Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Publish date: 2015-08-28
Tobacco Induced Diseases 2015;13(August):27
Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD), and smoking cessation is the only intervention that slows disease progression. It is important to know whether current factors related to smoking and smoking cessation are different among subjects with and without COPD in order to support smoking cessation. The aim of this study was to evaluate factors related to smoking cessation and to compare characteristics and nicotine dependence among smokers with and without COPD.

In 2005, 1614 subjects in a population-based longitudinal study of subjects with COPD and controls were examined. The Fagerström Test for Nicotine Dependence (FTND) and motivation for smoking cessation were assessed for current smokers (n = 299 total, 194 with COPD). Data on smoking cessation were collected in a follow-up in 2008 (n = 240).

Smokers with COPD had more pack-years and respiratory symptoms than smokers without COPD, whereas higher FTND scores were associated with anxiety/depression and respiratory symptoms in both groups. Nineteen percent of the smokers had quit smoking by the follow-up 3 years later, and they had significantly lower FTND scores (2.54 vs. 3.75, p < 0.001) and higher self-efficacy scores (10.0 vs. 6.0, p = 0.020) at baseline than the sustained smokers. Smoking cessation was related to low FTND scores and high self-efficacy independent of the presence of COPD, respiratory symptoms, anxiety/depression, and heart disease.

The FTND score and a simple visual analog scale for assessing self-efficacy seem to be valuable instruments for predicting smoking cessation over several years, independent of COPD, respiratory symptoms, presence of anxiety/depression, and heart disease.

Linnea Hedman   
Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, the OLIN Unit, Umeå University, Umeå, Sweden
1. Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347–65.
2. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3:e442.
3. Mannino D, Buist A. Global burden of COPD: risk factors, prevalence, and future trends. Lancet. 2007;370:765–73.
4. Lundbäck B, Lindberg A, Lindström M, Rönmark E, Jonsson A, Jönsson E, et al. Not 15 but 50 % of smokers develop COPD?--Report from the Obstructive Lung Disease in Northern Sweden Studies. Respir Med. 2003;97:115–22.
5. Lindberg A, Bjerg A, Rönmark E, Larsson LG, Lundbäck B. Prevalence and underdiagnosis of COPD by disease severity and the attributable fraction of smoking Report from the Obstructive Lung Disease in Northern Sweden Studies. Respir Med. 2006;100:264-72.
6. Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J. 2009;33:1165–85.
7. Anthonisen NR, Connett JE, Murray RP. Smoking and lung function of Lung Health Study participants after 11 years. Am J Respir Crit Care Med. 2002;166:675–9.
8. Godtfredsen NS, Prescott E. Benefits of smoking cessation with focus on cardiovascular and respiratory comorbidities. Clin Respir J. 2011;5:187–94.
9. Pelkonen M, Notkola IL, Tukiainen H, Tervahauta M, Tuomilehto J, Nissinen A. Smoking cessation, decline in pulmonary function and total mortality: a 30 year follow up study among the Finnish cohorts of the Seven Countries Study. Thorax. 2001;56:703–7.
10. Eisenberg MJ, Filion KB, Yavin D, Belisle P, Mottillo S, Joseph L, et al. Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials. CMAJ. 2008;179:135–44.
11. Eklund BM, Nilsson S, Hedman L, Lindberg I. Why do smokers diagnosed with COPD not quit smoking? - a qualitative study. Tob Induc Dis. 2012;10:17-9625-10-17.
12. Jimenez-Ruiz CA, Masa F, Miravitlles M, Gabriel R, Viejo JL, Villasante C, et al. Smoking characteristics: differences in attitudes and dependence between healthy smokers and smokers with COPD. Chest. 2001;119:1365–70.
13. 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;61:1043–7.
14. Hymowitz N, Cummings KM, Hyland A, Lynn WR, Pechacek TF, Hartwell TD. Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tob Control. 1997;6 Suppl 2:S57–62.
15. Breslau N, Johnson EO. Predicting smoking cessation and major depression in nicotine-dependent smokers. Am J Public Health. 2000;90:1122–7.
16. Transdisciplinary Tobacco Use Research Center (TTURC) Tobacco Dependence, Baker TB, Piper ME, McCarthy DE, Bolt DM, Smith SS, et al. Time to first cigarette in the morning as an index of ability to quit smoking: implications for nicotine dependence. Nicotine Tob Res. 2007;9 Suppl 4:S555–70.
17. Fagerstrom K, Furberg H. A comparison of the Fagerstrom Test for Nicotine Dependence and smoking prevalence across countries. Addiction. 2008;103:841–5.
18. Lindberg A, Lundbäck B. The Obstructive Lung Disease in Northern Sweden Chronic Obstructive Pulmonary Disease Study: design, the first year participation and mortality. Clin Respir J. 2008;2 Suppl 1:64–71.
19. Mahler DA, Wells CK. Evaluation of clinical methods for rating dyspnea. Chest. 1988;93:580–6.
20. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991;86:1119–27.
21. Rollnick S, Butler CC, Kinnersley P, Gregory J, Mash B. Motivational interviewing. BMJ. 2010;340:c1900.
22. Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40:1324–43.
23. Vozoris NT, Stanbrook MB. Smoking prevalence, behaviours, and cessation among individuals with COPD or asthma. Respir Med. 2011;105:477–84.
24. Schneider C, Jick SS, Bothner U, Meier CR. COPD and the risk of depression. Chest. 2010;137:341–7.
25. Breslau N, Kilbey MM, Andreski P. Nicotine dependence and major depression. New evidence from a prospective investigation. Arch Gen Psychiatry. 1993;50:31–5.
26. Berlin I, Singleton EG. Nicotine dependence and urge to smoke predict negative health symptoms in smokers. Prev Med. 2008;47:447–51.
27. Weinberger AH, Mazure CM, Morlett A, McKee SA. Two decades of smoking cessation treatment research on smokers with depression: 1990–2010. Nicotine Tob Res. 2013;15:1014–31.
28. Baillie AJ, Mattick RP, Hall W. Quitting smoking: estimation by meta-analysis of the rate of unaided smoking cessation. Aust J Public Health. 1995;19:129–31.
29. Borland R, Partos TR, Yong HH, Cummings KM, Hyland A. How much unsuccessful quitting activity is going on among adult smokers? Data from the International Tobacco Control Four Country cohort survey. Addiction. 2012;107:673–82.
30. Schnoll RA, Goelz PM, Veluz-Wilkins A, Blazekovic S, Powers L, Leone FT, et al. Long-term nicotine replacement therapy: a randomized clinical trial. JAMA Intern Med. 2015;175(4):504–11.
31. Gwaltney CJ, Metrik J, Kahler CW, Shiffman S. Self-efficacy and smoking cessation: a meta-analysis. Psychol Addict Behav. 2009;23:56–66.
32. Bakke PS, Ronmark E, Eagan T, Pistelli F, Annesi-Maesano I, Maly M, Meren M, Vermeire Dagger P, Vestbo J, Viegi G, Zielinski J, Lundback B, European Respiratory Society Task Force. Recommendations for epidemiological studies on COPD. Eur Respir J 2011; 38: 1261-77.
1. Determinants of Nicotine Dependence in Chronic Obstructive Pulmonary Disease
Yun Su Sim, Jin Hwa Lee, Ki Uk Kim, Seung Won Ra, Hye Yun Park, Chang-Hoon Lee, Deog Kyeom Kim, Kyeong-Cheol Shin, Sang Haak Lee, Hun Gyu Hwang, Joong Hyun Ahn, Yong Bum Park, Yu-Il Kim, Kwang Ha Yoo, Ina Jeong, Yeon-Mok Oh, Sang-Do Lee
Tuberculosis and Respiratory Diseases
2. Ignoring theory and misinterpreting evidence: the false belief in fear appeals
Gerjo Kok, Gjalt-Jorn Y. Peters, Loes T. E. Kessels, Gill A. ten Hoor, Robert A. C. Ruiter
Health Psychology Review
3. Self-efficacy in treating tobacco use: A review article
Rami Azmi Elshatarat, Mohammed Ibrahim Yacoub, Fadi Marwan Khraim, Zyad Taher Saleh, Tareq Rateb Afaneh
Proceedings of Singapore Healthcare
4. Determinants of preferences for lifestyle changes versus medication and beliefs in ability to maintain lifestyle changes. A population-based survey
Dorte Ejg Jarbøl, Pia Veldt Larsen, Dorte Gyrd-Hansen, Jens Søndergaard, Carl Brandt, Anja Leppin, Benedicte Lind Barfoed, Jesper Bo Nielsen
Preventive Medicine Reports
5. Changes in smoking prevalence and cessation support, and factors associated with successful smoking cessation in Swedish patients with asthma and COPD
Marcus Stegberg, Mikael Hasselgren, Scott Montgomery, Karin Lisspers, Björn Ställberg, Christer Janson, Josefin Sundh
European Clinical Respiratory Journal
6. Cigarette Use and Striatal Dopamine D2/3 Receptors: Possible Role in the Link between Smoking and Nicotine Dependence
Kyoji Okita, Mark A. Mandelkern, Edythe D. London
International Journal of Neuropsychopharmacology
7. Pilot Tobacco Treatment Intervention for Women in Residential Treatment for Substance Use Disorder
Amanda Fallin-Bennett, Janine Barnett, Letitia Ducas, Amanda T. Wiggins, Andrea McCubbin, Kristin Ashford
Journal of Obstetric, Gynecologic & Neonatal Nursing
8. Self-perceived ability to cope with stress and depressive mood without smoking predicts successful smoking cessation 12 months later in a quitline setting: a secondary analysis of a randomized trial
Eva Nohlert, John Öhrvik, Ásgeir R. Helgason
BMC Public Health
9. ¿Existe asociación entre el grado de dependencia por la nicotina y la motivación para dejar de fumar?
José Ignacio de Granda-Orive, José Francisco Pascual-Lledó, Santos Asensio-Sánchez, Segismundo Solano-Reina, Marcos García-Rueda, Manuel Ángel Martínez-Muñiz, Lourdes Lázaro-Asegurado, Daniel Bujulbasich, Rogelio Pendino, Susana Luhning, Isabel Cienfuegos-Agustín, Carlos A. Jiménez-Ruiz
Archivos de Bronconeumología