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Smoking and smoking cessation among people with chronic obstructive pulmonary disease (COPD)

Guanzhang J, Maclagan L, To T, Aaron SD, Yao Z, Gershon AS. Can Respir J Crit Care Sleep Med. 2019; Dec 18 [Epub ahead of print]. DOI:

Rationale — Despite its importance as a leading risk factor for chronic obstructive pulmonary disease (COPD), there is a minimal amount of population-level information regarding smoking prevalence among people with COPD.

Objectives — The objectives were to describe trends in smoking prevalence, cessation counseling and success among persons with COPD in Ontario, Canada.

Methods — We conducted a repeated cross-sectional study among individuals with physician-diagnosed COPD using a linked survey and health administrative data between 2005 and 2012. Survey respondents aged 40 and older were stratified on presence of physician-diagnosed COPD. Responses were used to determine smoking status and cessation success; health administrative data were used to determine smoking cessation counseling.

Measurement and Main Results — In 2012, the age-sex standardized prevalence of smoking in the COPD population was 31.1% (95% CI 30.3–32.1), more than double the general population prevalence (12.2%, 95% CI 12.6–13.1), with no decrease over the study period. COPD smokers received cessation counseling twice as often as general population smokers (21.9%, 95% CI 20.4–23.5 vs 12.8%, 95% CI 12.1–13.5), but had similar quit rates (6.7%, 95% CI 5.9–7.6 vs 6.6%, 95% CI 6.2–7.0).

Conclusion — Smoking prevalence continues to be high in people with COPD, and higher rates of smoking cessation counseling do not result in greater quit rates. Smoking cessation strategies may need better tailoring to the COPD population to achieve smoking cessation success.