Effects of Respiratory Disorders on Smoking Cessation and Re-Initiation in an Italian Cohort Study

Abstract

The present study aims to prospectively assess the influence of respiratory disorders on smoking cessation and re-initiation. Three population-based Italian cohorts answered a questionnaire on respiratory health and smoking habits during 1998-2001 and after a mean follow-up (SD) of 9.1 (0.8) years. Out of 1874 current smokers and 1166 ex-smokers at baseline, 965 (51.5%) and 735 (63.0%) reported their smoking status at follow-up. From current smokers, 312 had stopped smoking at follow-up, while 86 ex-smokers had resumed smoking. People reporting asthma at baseline were more likely to stop smoking than the other subjects (48.6% vs. 31.7%), while people reporting allergic rhinitis or chronic cough/phlegm had a higher probability to resume smoking (16.7% vs. 10.5% and 20.7% vs. 10.4%, respectively). In the multivariable logistic model, smoking relapse strongly decreased with increasing abstinence duration in people without chronic cough/phlegm (OR for ≥7.5 years vs. <7.5 years = 0.23, 95% CI 0.20-0.27), while no effect was detected in people with chronic cough/phlegm (p for interaction = 0.039). Smoking cessation was enhanced in asthmatic subjects, while people with allergic rhinitis or chronic cough/phlegm were at higher risk to resume smoking. Chronic cough/phlegm blunted the decrease in smoking resumption associated with longer abstinence duration.

Keywords: abstinence duration; allergic rhinitis; asthma; chronic bronchitis; smoking cessation; smoking intensity; smoking re-initiation.

Figure 1

The Odds Ratio (OR) of smoking cessation and re-initiation as a function of respiratory disorders, investigated among current smokers and ex-smokers at baseline, respectively. ORs of smoking cessation and related p-values were obtained by a logistic model, controlling for centre, sex, age, number of cigarettes smoked daily, and age of smoking initiation. When investigating smoking re-initiation, age at smoking initiation was replaced in the logistic model by years of smoking abstinence until baseline.