The link between chronic obstructive pulmonary disease (COPD) and asthma and smoking is well established. However, a recent multicenter trial from Turkey has shown that immediately linking patients who smoke to a smoking cessation clinic can significantly improve quit rates. This trial, conducted by Dilek Karadogan, MD, at Recep Tayyip Erdoğan University, revealed that patients who were randomized to an immediate appointment at a smoking cessation clinic had a 27% quit rate at 3 months, compared to 17% with usual care involving referral to a smoking quitline.
Karadogan emphasized that smoking cessation aid should be a routine part of care for patients with chronic airway diseases. The study demonstrated a five-fold increase in quit rates with evidence-based smoking cessation assistance. Additionally, the rate of access to this help was higher in the immediate-appointment group than in the usual-care group. The findings suggest that providing immediate support and access to smoking cessation services can have a significant impact on quit rates among patients with COPD and asthma.
The study also highlighted that a significant proportion of patients with chronic lung diseases, such as COPD and asthma, continue to smoke even after diagnosis. Standard brief tobacco cessation interventions, like the “5A” method, have shown limited impact on this patient population. While a majority of smokers express a desire to quit, only a small percentage are able to achieve prolonged abstinence. This underscores the importance of tailored smoking cessation programs for patients with COPD and asthma.
One of the limitations of the study was the lack of biochemical verification of tobacco cessation. However, the differences in quit rates between the immediate-appointment group and the control group were sustained at 1 year follow-up. This indicates that the benefits of immediate access to smoking cessation services can have lasting effects on patients with chronic airway diseases.
The multicenter trial randomized 397 adult smokers with COPD, asthma, or bronchiectasis to an immediate-appointment group or a control group. Patients in the intervention arm were scheduled for an appointment at a smoking cessation clinic, where they received free smoking cessation therapy. The control group received standard care, which involved advising patients to make an appointment at a clinic. Access to evidence-based treatment, including pharmacotherapy like nicotine replacement therapy and bupropion, was provided to the intervention group.
At 3 months, the immediate-appointment group had higher rates of attendance at smoking cessation clinics and receipt of evidence-based medication to help them quit smoking. Rates of NRT and bupropion use were significantly higher in the immediate-appointment arm compared to the control group. The study found that participants in the immediate-appointment arm had higher levels of education, Fagerstrom Test for Nicotine Dependence scores, and forced expiratory volume in 1 second.
The findings of this study emphasize the importance of integrating smoking cessation support into routine care for patients with COPD and asthma who smoke. Immediate access to smoking cessation services can significantly improve quit rates and contribute to better long-term outcomes for these patients. More research is needed to explore the effectiveness of different cessation interventions tailored to the unique needs of patients with chronic airway diseases.
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