Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2018 Aug;154(2):274-285.
doi: 10.1016/j.chest.2018.02.007. Epub 2018 Feb 22.

Changes and Clinical Consequences of Smoking Cessation in Patients With COPD: A Prospective Analysis From the CHAIN Cohort

Cristina Martínez-González  1 , Ciro Casanova  2 , Juan P de-Torres  3 , José M Marín  4 , Pilar de Lucas  5 , Antonia Fuster  6 , Borja G Cosío  7 , Myriam Calle  8 , Germán Peces-Barba  9 , Ingrid Solanes  10 , Ramón Agüero  11 , Nuria Feu-Collado  12 , Inmaculada Alfageme  13 , Amparo Romero Plaza  14 , Eva Balcells  15 , Alfredo de Diego  16 , Margarita Marín Royo  17 , Amalia Moreno  18 , Antonia Llunell Casanovas  19 , Juan B Galdiz  20 , Rafael Golpe  21 , Celia Lacárcel Bautista  22 , Carlos Cabrera  23 , Alicia Marin  24 , Joan B Soriano  25 , Jose Luis Lopez-Campos  26 ; CHAIN Study Investigators
Affiliations
Multicenter Study

Changes and Clinical Consequences of Smoking Cessation in Patients With COPD: A Prospective Analysis From the CHAIN Cohort

Cristina Martínez-González et al. Chest. 2018 Aug.

Abstract

Background: Despite the existing evidence-based smoking cessation interventions, chances of achieving that goal in real life are still low among patients with COPD. We sought to evaluate the clinical consequences of changes in smoking habits in a large cohort of patients with COPD.

Methods: CHAIN (COPD History Assessment in Spain) is a Spanish multicenter study carried out at pulmonary clinics including active and former smokers with COPD. Smoking status was certified by clinical history and co-oximetry. Clinical presentation and disease impact were recorded via validated questionnaires, including the London Chest Activity of Daily Living (LCADL) and the Hospital Anxiety and Depression Scale (HADS). No specific smoking cessation intervention was carried out. Factors associated with and clinical consequences of smoking cessation were analyzed by multivariate regression and decision tree analyses.

Results: One thousand and eighty-one patients with COPD were included (male, 80.8%; age, 65.2 [SD 8.9] years; FEV1, 60.2 [20.5]%). During the 2-year follow-up time (visit 2, 906 patients; visit 3, 791 patients), the majority of patients maintained the same smoking habit. Decision tree analysis detected chronic expectoration as the most relevant variable to identify persistent quitters in the future, followed by an LCADL questionnaire (cutoff 9 points). Total anxiety HADS score was the most relevant clinical impact associated with giving up tobacco, followed by the LCADL questionnaire with a cutoff value of 10 points.

Conclusions: In this real-life prospective COPD cohort with no specific antismoking intervention, the majority of patients did not change their smoking status. Our study also identifies baseline expectoration, anxiety, and dyspnea with daily activities as the major determinants of smoking status in COPD.

Trial registry: ClinicalTrials.gov; No. NCT01122758; URL: www.clinicaltrials.gov.

Keywords: COPD; cohort studies; smoking cessation; tobacco.

PubMed Disclaimer

Publication types

Associated data