PREDICTORS OF SMOKING CESSATION AMONG LONG-TERM CIGARETTE USERS WITH COPD

ZACHARY C Rich; ALEJANDRO P Comellas; SPYRIDON Fortis

doi:10.1016/j.chest.2024.06.3701

PURPOSE: This study aimed to investigate the predictive value of clinical factors, including dyspnea burden and exercise capacity, on smoking cessation among individuals with Chronic Obstructive Pulmonary Disease (COPD). METHODS: Data from the COPDGene study, a multicenter observational cohort, were analyzed. Participants with ≥10 pack-years smoking history and complete data for three follow-up visits were included. Smoking status, dyspnea burden (measured by modified Medical Research Council scale), and exercise capacity (measured by 6-minute walk distance) were assessed at each visit. Multivariable logistic regression models were utilized to assess the association between clinical variables and smoking cessation. RESULTS: Among the 10,194 participants initially included, 2,012 had complete data for all three visits. After exclusions, participants who quit smoking at the final visit were significantly older(p=0.011), had lower rates of cigarettes /day prior to quitting (p=0.001), had a lower post-bronchodilator FEV1 (p=0.038), and were more likely to have had at least one COPD exacerbation in the 12 months prior to visit 2 (p=0.007). In an adjusted analysis, the odds of quitting smoking was not significantly higher among those with a higher mMRC (OR 1.29, 95%CI 0.83-2.01) or higher SGRQ (OR 1.41, 95% CI 0.89-2.23). However, higher odds of quitting were seen with a six-minute walk distance less than 240 meters (OR 2.27, 95% CI 1.10-4.51). CONCLUSIONS: Older age, lower daily cigarette consumption, and recent COPD exacerbation were associated with successful smoking cessation, consistent with prior research. Notably, dyspnea burden did not independently predict cessation, while loss of exercise capacity demonstrated significant predictive value. These findings underscore the importance of personalized interventions in smoking cessation programs tailored to COPD patients. CLINICAL IMPLICATIONS: The study emphasizes the need to consider exercise capacity, rather than dyspnea burden alone, when designing smoking cessation interventions for individuals with COPD. Identifying predictors of smoking cessation enables targeted interventions, optimizing resource allocation and improving individual health outcomes in this population.

PREDICTORS OF SMOKING CESSATION AMONG LONG-TERM CIGARETTE USERS WITH COPD

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