Improving Smoking Cessation Rates Among Patients with COPD and Asthma: A Multicenter Trial Analysis

Improving Smoking Cessation Rates Among Patients with COPD and Asthma: A Multicenter Trial Analysis

A recent multicenter trial from Turkey has shed light on the effectiveness of immediately linking chronic obstructive pulmonary disease (COPD) and asthma patients who smoke to a smoking cessation clinic. The study, conducted by Dilek Karadogan, MD, at Recep Tayyip Erdoğan University, revealed promising results in terms of quit rates among participants. This article aims to critically analyze the trial and its implications for patients with chronic airway diseases.

The trial recruited nearly 400 smokers from respiratory clinics, with the participants randomized to either an immediate appointment at an outpatient smoking cessation clinic or usual care, which involved referral to a smoking quitline. The self-reported quit rates at 3 months were significantly higher in the group that received immediate appointments at the cessation clinic (27% vs. 17% with usual care; P=0.014). Furthermore, the study showed a five-fold increase in quit rates with evidence-based smoking cessation assistance, highlighting the importance of incorporating smoking cessation aid into routine care for patients with chronic airway diseases.

According to Karadogan, a significant proportion of patients with chronic lung diseases continue to smoke tobacco even after their diagnosis. Data from the CDC indicates that 38% of COPD patients and 21% of asthma patients in the U.S. are current smokers, underscoring the need for targeted smoking cessation interventions in this population. However, there is limited information on the impact of standard tobacco cessation methods for patients with COPD or asthma.

Discussant Armin Frille, MD, highlighted the low success rates of self-quitters and the importance of evidence-based smoking cessation strategies. The study results align with previous research on smoking cessation interventions, emphasizing the need for immediate support and access to pharmacotherapy for quitting tobacco. While the trial had some limitations, such as the lack of biochemical verification of tobacco cessation and concerns about the sustainability of quit rates beyond 1 year, the findings suggest that early intervention and comprehensive cessation support can significantly improve outcomes for COPD and asthma patients who smoke.

The multicenter trial conducted from November 2022 to June 2023 included 397 adults with COPD, asthma, or bronchiectasis who were current smokers. Participants were randomized to receive either an immediate appointment at a smoking cessation clinic or standard care. Both groups received brief smoking cessation recommendations, but the intervention arm had access to free smoking cessation therapy and evidence-based pharmacotherapy. The primary endpoint of self-reported quit rates at 3 months showed a significant difference between the two groups, with higher rates of quitting observed in the immediate-appointment arm.

The multicenter trial from Turkey provides valuable insights into the effectiveness of linking COPD and asthma patients who smoke to smoking cessation clinics. The study demonstrates the importance of integrating smoking cessation aid into routine care for patients with chronic airway diseases and highlights the significant increase in quit rates with evidence-based support. Moving forward, healthcare providers should consider early intervention and comprehensive cessation strategies to improve smoking cessation rates among patients with COPD and asthma.

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