Chart 6. Recommendations for the approach to smoking cessation and benefits of cessation in patients with COPD.
| Description | Recommendations |
|---|---|
| Consultation | All patients with COPD should be asked if they smoke and, if so, should be encouraged to stop smoking and referred to a smoking cessation program. |
| Start of treatment | Smoking cessation treatment alters the natural course of COPD. |
| Begin smoking cessation treatment as part of COPD treatment. | |
| Treatment strategy | Combining behavioral counseling with first-line drugs (nicotine replacement therapy, bupropion, and varenicline) is the most effective approach. |
| Patients who have more difficulty in quitting smoking can benefit from the use of more than one drug or high-dose nicotine patches. | |
| Benefits of smoking cessation | In patients with COPD, the benefits vary depending on age, severity, and comorbidities. Main benefits: Slows the progressive decline in FEV1 Reduces exacerbation and hospitalization rates Minimizes respiratory symptoms and improves quality of life Reduces the limitations in activities of daily living Improves the ability to perform activities of daily living Improves the control of comorbidities Improves the response to bronchodilators and inhaled corticosteroids |
Based on Jiménez-Ruiz et al. 20 ; Jiménez-Ruiz et al. 22 van Eerd et al. 33 ; the Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 70 ; the U.S. Department of Health and Human Services 71 ; Bai et al. 88 ; Tonnesen et al. 89 ; Godtfredsen et al. 90 ; Anthonisen et al. 91 ; and Anthonisen et al. 92