Understanding barriers to Smoking Cessation on COPD Patients: A prevalence study

Abstract

Introduction - COPD is an emerging public health problem. Smoking cessation must be a priority in the management of COPD. The aim of the study was to investigate the reasons that make smoking cessation difficult in patients with COPD, in order to outline future public health strategies. Methods - COPD patients, with a history of smoking, who underwent spirometry between Jan 2020 and Jun 2021 at CHVNG/E were included. A telephone questionnaire was carried out, including data collection of age, sex, BMI, occupational exposure, literacy, comorbidities, COPD and exacerbations characterization, and validated scales for dyspnea and tobacco dependence. The symptoms of anxiety and depression were recorded, as well as the usual intake of alcohol, coffee and anxiolytics/antidepressants. Smoking history and habits, smoking-packs year, age of smoking onset, intention to quit smoking, use of medication, medical monitoring and reasons to return smoking were surveyed. Finally, the biggest obstacle to smoking cessation was asked to all participants and the most relevant reason to quit, in ex-smokers. The variables were compared between different groups of smokers/ex-smokers and student's t-tests were used with a level of significance of 0.05. Results - Data was collected from 168 participants. Stress was identified as the main reason to restart smoking for 43,0% of ex-smokers, and the biggest obstacle to quit smoking for 41.3% of the participants. The group of smokers who tried to quit smoking and smokers who never tried, showed more symptoms of anxiety (p <0.001 and p <0.001, respectively) and depression (p = 0.002 and p = 0.007, respectively) than the group of ex-smokers. There was an increasing incidence of ex-smokers, as the GOLD classification worsened (p=0.001). A negative correlation was found between literacy and smoking load and the level of smoking dependence, and a positive correlation between anxiety symptoms and smoking-packs year (p<0.001), and between depression and mMRC (p=0.003). Conclusions - Anxiety/stress and depression were the most referred relevant variables in the success of smoking cessation in COPD patients. Clinical intervention, information about the dangers of tobacco and choice of the ideal time to quit smoking will increase successful attempts.