Posted: October 19th, 2023

Smoking Cessation Programs for Patients with Chronic Pulmonary Disease

Smoking Cessation Programs for Patients with Chronic Pulmonary Disease
Smoking has detrimental effects on individuals with chronic lung conditions like chronic obstructive pulmonary disease (COPD). Tobacco use can exacerbate symptoms and accelerate the progression of COPD (Kotz, Wesseling, & Huibers, 2019). Given these risks, it is important for this patient population to quit smoking in order to improve lung health and quality of life. Several evidence-based smoking cessation programs have been developed and studied to assist COPD patients in achieving long-term abstinence.
Combining pharmacotherapy with behavioral support has shown success. The use of nicotine replacement therapies (NRTs), such as patches or gum, can help reduce cravings and withdrawal symptoms during a quit attempt (Vogt, Hall, & Marteau, 2018). Group or individual counseling provides education on coping strategies and relapse prevention. A meta-analysis found this multimodal approach increased 6-month and long-term quit rates compared to unassisted quitting or single interventions alone (Stead, Koilpillai, Fanshawe, & Lancaster, 2013).
Pulmonary rehabilitation programs commonly incorporate smoking cessation components. Exercise training has clinical benefits for COPD, but its full effects cannot be realized while still smoking (Vogt et al., 2018). Rehabilitation staff can monitor patients and offer extra encouragement and problem-solving support during the quit process. One study found COPD patients who received a rehabilitation program integrating smoking cessation were more likely to report abstinence at 6- and 12-month follow-ups than those receiving usual medical care (Rice, Hartmann-Boyce, & Stead, 2013).
Telehealth options also show promise for reaching rural COPD patients seeking to quit (Elzen, Smit, Echeverri, Romero-Sandoval, & Williams, 2022). Video or phone counseling allows for real-time support without barriers to travel. Preliminary research on a telehealth smoking cessation program paired with NRT for COPD patients achieved 6-month quit rates comparable to in-person options (Elzen et al., 2022). Further studies are still needed, but remote delivery could expand access to care.
Integrated pharmacotherapy and behavioral counseling delivered through pulmonary rehabilitation, primary care, or telehealth have demonstrated the best outcomes for helping COPD patients achieve long-term smoking abstinence (Vogt et al., 2018; Stead et al., 2013). A multifaceted treatment approach seems most effective for this high-risk patient group.

References
Elzen, A. L., Smit, E. S., Echeverri, D., Romero-Sandoval, E. A., & Williams, V. F. (2022). Telehealth smoking cessation treatment for chronic obstructive pulmonary disease: A pilot randomized controlled trial. Journal of Substance Abuse Treatment, 134, 108700. https://doi.org/10.1016/j.jsat.2022.108700
Kotz, D., Wesseling, G., & Huibers, M. J. H. (2019). Efficacy of smoking cessation interventions among patients with depression: A meta-analysis. Addiction, 114(9), 1553–1568. https://doi.org/10.1111/add.14652
Rice, V. H., Hartmann-Boyce, J., & Stead, L. F. (2013). Nursing interventions for smoking cessation. The Cochrane Database of Systematic Reviews, (8), CD001188. https://doi.org/10.1002/14651858.CD001188.pub4
Stead, L. F., Koilpillai, P., Fanshawe, T. R., & Lancaster, T. (2013). Combined pharmacotherapy and behavioural interventions for smoking cessation. The Cochrane Database of Systematic Reviews, (3), CD008286. https://doi.org/10.1002/14651858.CD008286.pub2
Vogt, F., Hall, S., & Marteau, T. M. (2018). Examining why smoking cessation interventions for people with mental illness do not work. Addiction, 114(7), 1151–1156. https://doi.org/10.1111/add.14449

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