Smoking Cessation More Difficult in Patients With vs Without COPD

quitting smoking
hand throwing unused cigarettes in the bin. The beginning of giving up nicotine and becoming a non smoker on medical advice
Researchers analyzed the rates of successful smoking cessation in US adults with vs without chronic obstructive pulmonary disease.

Individuals with chronic obstructive pulmonary disease (COPD) who attempt to stop smoking are less likely to succeed than those without the disorder, according to a study published in the American Journal of Preventive Medicine.

Researchers sought to evaluate the latest estimates of smoking cessation among US adults both with and without COPD who were ever-smokers, meaning they had ever smoked cigarettes. Analysis of the “quit ratio” was restricted to a total of 161,233 adult respondents who were ever-smokers, had ever lived in the 50 US states or DC, and had complete information related to selected characteristics. Cigarette smoking status was defined by 2 questions: (1) Have you smoked at least 100 cigarettes in your entire life? (2) Do you currently smoke every day, some days, or not at all? Data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS)—a random-digit-dialing landline and cellular telephone survey conducted by state health departments in collaboration with the US Centers for Disease Control and Prevention in all 50 US states, the District of Columbia (DC), and the US territories—were analyzed in 2020.

Multivariable logistic regression analyses, with adjustment for sociodemographic characteristics, health risk behaviors, asthma, and depression, were used to obtain weighted percentages of quit ratios (ie, proportion of ever-smokers who quit smoking), past-year quit attempts (ie, ≥1 per day), and recent successful smoking cessation (ie, quit ≥6 months ago) by self-reported physician-diagnosed COPD.

Results of the study showed that among the ever-smokers, 12.8% had COPD. Ever-smokers with COPD were significantly more likely to be women, to be 45 years of age or older, to be adults with a high school diploma or lower level of education, to be retired or unable to work, to have lower than 200 federal poverty level family income, to live in micropolitan or noncore (ie, rural) counties, to report having no leisure-time physical activity, to smoke currently, to have obesity, to have depression, and to have current or former asthma, compared with ever-smokers without COPD (P <.01).

The respondents with vs without COPD reported having higher age-adjusted prior-year quit attempts (68% vs 64.3%, respectively), but lower age-adjusted successful cessation (4.5% vs 5.8%, respectively) and quit ratio (53.2% vs 63.9%, respectively). Following adjustment for covariates, those adults with COPD who smoked had a significantly higher percentage of past-year quit attempts, but similar successful cessation and a significantly lower lifetime quit ratio than individuals without COPD.

“Evidence-based treatments for smoking cessation remain an important component of a comprehensive approach to helping all adults to quit and are a particularly important element of COPD management and care,” the study authors noted.

Disclosure: None of the study authors has declared affiliations with biotech, pharmaceutical, and/or device companies.  


Liu Y, Greenlund KJ, VanFrank B, Xu F, Lu H, Croft JB. Smoking cessation among U.S. adult smokers with and without chronic obstructive pulmonary disease, 2018.Am J Prev Med. Published online February 1, 2022. doi:10.1016/j.amepre.2021.12.001

This article originally appeared on Pulmonology Advisor