Smoking cessation motivation in patients with chronic obstructive pulmonary disease depending on the intensity of smoking

Objective: to assess smoking cessation motivation in patients with chronic obstructive pulmonary disease (COPD) depending on the intensity of smoking and the clinical picture of the disease.

Materials and methods. The study included 100 patients aged 36 to 81 years (62,0 [53,0; 69,0] years). A questionnaire was administered using the Horn test to determine the type of smoking behavior (HST), the Fagerstrom test to determine the degree of nicotine dependence (DND); and determination of smoking cessation using the Prohaska questionnaire. Statistical processing was performed using the Statistica 10 software package, using nonparametric statistics methods.

Results: All patients with COPD were tobacco smokers: 69 people were current smokers (group 1), 31 respondents were former smokers (group 2), and at the time of the examination, the period of smoking cessation was 1,5 years or more. The groups did not differ in age, duration of the smoking history and smoking index, COPD duration, dyspnea severity according to the mMRC scale, and post-bronchodilation FEV1. The SAT test in group 1 was 25,0 [20,0; 30,0] points, in group 2 – 21,0 [16,0; 30,0] points, p = 0,03. The predominant type of smoking behavior in both groups was the “Relaxation” type, detected in 46,38% and 58,06 %, respectively. Former smokers had a history of very weak degree of nicotine dependence more often and did not have weak or high degree of nicotine dependence. Degree of nicotine dependence in former smokers was 2,19 ± 2,46 points, in current smokers – 5,13 ± 2,43 points, p = 0,00002. Current smokers had not smoking cessation motivation in 44,92%, low motivation in 14,49%, high motivation in 40,57%. All smoking patients with very low degree of nicotine dependence had a strong smoking cessation motivation. Opposite, the majority of patients with very high degree of nicotine dependence (14 patients, 93.3%) showed no smoking cessation motivation. More than half of the patients with medium degree of nicotine dependence had higher smoking cessation motivation. Smoking cessation motivation did not depend on age, gender, COPD class and type of smoking behavior.

Conclusion: 69% of patients with COPD are current smokers, this group has a higher degree of nicotine dependence and greater severity of respiratory symptoms, compared with former smokers . Current smokers had not smoking cessation motivation in 44.92%, low motivation in 14.49%, high motivation in 40.57%. Smoking cessation motivation was lower in patients with high degree of nicotine dependence.

1. Avdeev S.N., Leshchenko I.V., Aisanov Z.R. et al. on behalf of the working group for the development and revision of Federal clinical guidelines for COPD. New clinical guidelines for COPD – a paradigm shift: A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2024. 96 (3).292–297. (In Russ.). DOI: 10.26442/00403660.2024.03.202646.

2. WHO report on the global tobacco epidemic, 2023: protect people from tobacco smoke. 31 July 2023. https://www.who.int/publications/i/item/9789240077164 ISBN: 978-92-4-007716-4.

3. Jackson H., Hubbard R. Detecting chronic obstructive pulmonary disease using peak flow rate: cross sectional survey. BMJ 2003. 327 (7416). 653-4. 56 DOI: 10.1136/bmj.327.7416.653.

4. Salvi S.S. Tobacco Smoking and Environmental Risk Factors for Chronic Obstructive Pulmonary Disease. Clinics in Chest Medicine. 2014. 35(1).17-27. https://doi.org/10.1016/j.ccm.2013.09.011

5. Tobacco dependence syndrome, tobacco withdrawal syndrome in adults, clinical guidelines, 58 р. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/http://gbuzrkkrnd.ru/f/000897.pdf, д Accessed: 04.11.2024.

6. Global Initiative for Chronic Obstructive Lung Disease. 2023. https://goldcopd.org/2023-gold-report-2/ Accessed: 29.12.2024.

7. Vogelmeier C.F., Román-Rodríguez M., Singh D. et al. Goals of COPD treatment: Focus on symptoms and exacerbations. Respir Med. 2020.166.105938. doi: 10.1016/j.rmed.2020.105938.

8. Pelevina I.D., Shaporova N.L., Trofimov V.I. et al. Gender peculiarities of smoking status, level of the nicotine dependence, respiratory symptoms and motivation to tobacco cessation. The Scientific Notes of IPP-SPSMU. 2018. 25 (2). 39–45. (In Russ.). DOI: 10.24884/1607-4181-2018-25-2-39-45.

9. Lareva N.V., Zueva A.A., Luzina E.V., Demidova L.P., Elizbaryan O.A.Tobacco addiction in chronic obstructive pulmonary disease: gender characteristics Problems of Women's Health. 2011.6(4).70-71. Proceedings of the VI Russian Conference "Problems of Women's Health and Ways to Solve Them". EDN OPQCHP. (In Russ.).

10. Chetverkina E. D., Kozyrev A. G., Ivanova G. A., Isaeva E. R., Kirillova A. I. Attitude to health and motivation to quit smoking in patients with chronic obstructive pulmonary disease. The Scientific Notes of IPP SPSMU. 2017. 24 (1). 68–73. (In Russ.). DOI: 10.24884/1607418120172416873.

11. Babak S.L., Gorbunova M.V., Malyavin A.G., Shashenkov I.V. The Concept of Harm Reduction from Tobacco: Past, Present, Future. The Russian Archives of Internal Medicine. 2021.11(6).405-415. (In Russ.). https://doi.org/10.20514/2226-6704-2021-11-6-405-415