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Rural Health Information Hub

Smoking Cessation Models for COPD

Smoking is the primary risk factor for COPD and can contribute to diminished lung function among COPD patients. Among individuals who smoke, cessation is one of the most effective ways to manage COPD symptoms and reduce morbidity.

A 2001 study in Chest found that smokers with COPD had greater nicotine dependency compared to other smokers, while a 2015 Respiration article reports that smokers with COPD had higher levels of depression, higher cigarette dependence, and lower self-efficacy to stop smoking than smokers without COPD.

A 2016 systematic literature review found the most effective smoking cessation strategy for patients with COPD included a combination of behavioral counseling and pharmacotherapy. It also found that using nicotine replacement therapy, as well as with smoking cessation aids like varenicline and bupropion, has shown higher relative efficacy in smoking cessation among smokers with COPD.

RHIhub has developed a Rural Tobacco Control and Prevention Toolkit that contains extensive information about smoking among rural populations, including statistics and examples of smoking cessation and other tobacco control programs.

Examples of Smoking Cessation Models

Typically, smoking cessation programs are not tailored specifically to smokers with COPD. Several examples of smoking cessation models can be found in the Rural Tobacco Control and Prevention Toolkit's Program Models section, with links to specific examples listed below.

Considerations for Implementation

Since smokers with COPD report less confidence in their ability to quit smoking, it's important to build self-efficacy. Additionally, a 2015 analysis mentioned several characteristics of effective smoking cessation counseling for patients with COPD, including:

  • Provide a clear explanation of the relationship between smoking and COPD. Explain that quitting smoking is the best option to slow the progression of COPD and improve outcomes.
  • Use spirometry results to increase motivation to quit.
  • Inform patients that inhaled treatments may not work as well if they continue to smoke.
  • Inform patients that quitting smoking can improve airflow obstruction, which alleviates COPD symptoms of breathlessness, cough, wheezing, and chest pain.

Resources to Learn More

Clear Horizons
A smoking cessation guide created for people aged 50 or older.
Organization(s): National Cancer Institute
Date: 6/2013

Smoking Cessation Effectiveness in Smokers with COPD and Asthma under Real Life Conditions
Study comparing the long-term effectiveness of a rigorous smoking cessation program between smokers with COPD, smokers with asthma, and a control group.
Author(s): Gratziou, C., Florou, A., Ischaki, E., Eleftheriou, K., Sachlas, A., Bersimis, S., & Zakynthinos, S.
Citation:Respiratory Medicine, 108 (4)
Date: 4/2014