Investigation of Smoking Cessation Status and Its Influencing Factors in Patients with Chronic Obstructive Pulmonary Disease.

Purpose: Chronic obstructive pulmonary disease (COPD) is a common disease with high prevalence, high mortality and high costs across the globe. Small airways are major sites contributing to airway resistance and the small airway disorder (SAD) is frequently implicated in early-stage COPD. Smoking is recognized as the leading cause of COPD and SAD. This study aimed to investigate the status quo and influencing factors of smoking cessation in patients with SAD or COPD, which is crucial for improving prevention and treatment of chronic airway diseases.

Patients and methods: In this multicenter, prospective cohort investigation, questionnaire survey and one-year follow-up study were conducted in SAD and COPD patients with smoking history. The rate of quitting intention, quitting attempt and recent smoking cessation of SAD or different stages of COPD and their influencing factors were recorded, compared and analyzed.

Results: A total of 386 valid questionnaires were collected. The rate of quitting intention was 91.7% (95% CI: 88.53-94.07%), and quitting attempt was 73.6% (95% CI: 68.96-77.73%). Regular bronchodilator use, alcohol abstinence, and the lower Fagerstrom Test for Nicotine Dependence (FTND) scores were associated with a higher intention to quit smoking. Further, inpatients with higher mMRC scores, non-smoking parents, engagement in pulmonary rehabilitation exercises, and receipt of medical advice to quit were more likely to attempt quitting smoking. In the one-year follow-up survey, the overall recent smoking cessation rate was 23.9%. The multivariate logistic regression analysis revealed that higher mMRC grade, carrying out pulmonary rehabilitation exercise and the quitting intention were positive factors for quitting smoking, while outpatients with lower educational level, higher FTND score and Tobacco Craving Questionnaire-Short Form (TCQ-SF) scores were negative influencing factors for recent smoking cessation.

Conclusion: Patients with SAD and COPD generally had a high willingness to quit smoking, but a significant reduction in the success rate of smoking cessation. Factors influencing smoking cessation included the severity of the illness, nicotine dependence, patient self-control, lifestyle and environment.