Abstract

ABAJO LARRIBA, Ana Beatriz de et al. Diagnosis and treatment of smoking in patients with chronic obstructive pulmonary disease: ADEPOCLE study. Nutr. Hosp. [online]. 2016, vol.33, n.4, pp.954-961. ISSN 1699-5198.  https://dx.doi.org/10.20960/nh.398.

Background and objectives: Smoking is the main cause of chronic obstructive pulmonary disease (COPD). The objective of this study is to estimate the prevalence of smoking and analyze how the COPD smokers are diagnosed and treated. Methods: Multicenter, epidemiological, transversal study (30 health centers in the province of Leon, Spain). It included patients over 35 years old diagnosed and treated for COPD. The analyzed variables are: age, sex, habitat, anthropometric data, smoking, pack-years cooximetry, dependence (analog-visual scale), motivation (Fagerström test), self-efficacy, mood, previous attempts, cognitive behavioral therapy, pharmacotherapy (NRT, bupropion, varenicline) and relapses. Results are expressed with CI 95.5%. Results: 833 patients were included. 85.8% males; mean age: 64.69 (53.66-75.61) years and 20.65 (4.47-36.8) years of COPD evolution. The 86.67% (80.30-93.30) had previous history of tabaquism (n = 722) with 35.26 (17.87-52.64) years of evolution and an average consumption of 28.36 (9.60-46.86) packs per year p < 0.001, 58% being heavy smokers. 57.4% (53.90-60.60) are former smokers. 29.3% (26.40-32.70) Smoking declared assets vs. 35.11% (33.90-37.12) smokers diagnosed by cooximetry p < 0.05. 288 active smokers had low motivation (49.80%), high dependence (49.5%), negative attitude (52.60%), low mood (32.05%), with 2.72 (1.74-3.67) attempts to quit smoking, p < 0.0001. The conductive-behavioral therapy (CBT) combined with drug treatment was performed in 55.8% (52.2 to 54.9), p < 0.05; the most effective intervention was CBT combined with varenicline achieving an abstinence of 29.86%. A total of 51.05% (49.49 to 52.70) out of the patients with COPD stopped smoking, p < 0.001. Conclusions: The prevalence of smoking in COPD in our environment remains unacceptably high. Greater involvement is required to reduce its impact on the health of these patients.

Keywords : COPD; Smoking; Motivation; Dependence; Cognitive behavioral therapy; Nicotine replacement therapy; Bupropion; Varenicline.

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