Characteristics Associated with Sustained Abstinence from Smoking Among Patients with COPD
Received 25 April 2005; accepted 21 September 2005.
Abstract
Purpose
Smoking cessation is the mainstay of recommended treatment for chronic obstructive pulmonary disease (COPD), yet many continue smoking. This study seeks to understand the characteristics of patients with COPD who have quit and those who have not quit to identify important factors to evaluate in smoking-cessation interventions.
Subjects/methods
A cross-sectional survey of a random sample of 1.5 million, predominantly male Veterans Administration enrollees. Of the respondents (63% [n = 887 775]), those with at least 1 COPD visit, a smoking history, and aged more than 34 years were included in this analysis (n = 89 337). Differences in demographics, functional status, comorbidities, and provider–patient interactions were evaluated for current and former smokers.
Results
Ninety-seven percent of the cohort with COPD was male. Former smokers (n = 58 482) were older (mean age of 69.6 vs 62.8, P<.001) and had more cardiac comorbidities, but better mental health (Mean Mental Component Summary score from the Veterans Short Form-36 ± standard deviation of 43.4 ± 13.2 vs 39.9 ± 13.7, P<.001) than current smokers (n = 25 595), respectively. In addition, former smokers more actively participated in their health care and had a better relationship with their provider than current smokers.
Conclusion
Former smokers with COPD were older, had more cardiac comorbidities, better mental health, and better perceived provider–patient interactions than active smokers. This study highlights the importance of screening participants with COPD who are enrolling in forthcoming smoking cessation trials for mental illnesses. In addition, developing interventions that address psychiatric comorbidities and potentially improve provider-patient communication may be other key areas to evaluate in future smoking cessation trials in patients with COPD.
aDepartment of Medicine, Division of Pulmonary Diseases/Critical Care Medicine, The University of Texas Health Science Center at San Antonio, Tex
bThe Veterans Evidence-based Research, Dissemination, and Implementation Center (VERDICT), South Texas Veterans Health Care System, San Antonio, Tex
cThe Center for Health Quality, Outcomes, and Economic Research, VAMC and Health Outcomes Technologies, Boston University School of Public Health, Boston, Mass
Requests for reprints should be addressed to Sandra G. Adams, MD, MS, Audie L. Murphy Memorial Veterans Hospital, Pulmonary Diseases Section (111E), 7400 Merton Minter Blvd. (111E), San Antonio, TX 78229
This work was supported by a Veterans Integrated Service Network (VISN-17) grant and The Office of Research and Development, Health Services R&D Service, Department of Veterans Affairs (Grant HFP 98-002). The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
ABSTRACT
