[Effect of treatment for nicotine dependence in patients with COPD]

Stopping smoking is the only known method to slow down the inevitable progression of COPD. Early detection of the disease in smokers at risk of COPD gives a unique opportunity to prevent the disease progression. The aim of the study was to evaluate the effects of smoking intervention in a group of subjects with newly diagnosed airflow limitation (AL). Of 558 current smokers participating in population spirometric screening for COPD combined with smoking cessation advice, 297 were diagnosed to have AL (FEV1/FVC < 0.7). After one year 193 presented for follow-up visit. Thirty subjects (10.1%) quit smoking. Remaining 163 smokers were invited to smokers' clinic. Attendees (n = 70), 40 males, and 30 females, mean age 56 years, were randomized at visit 1 to treatment with nicotine patch (n = 38) or bupropion SR (n = 32). Follow-up was scheduled at 2 weeks, at the end of treatment, 6 months and 12 months. After 12 months a phone call assessed the smoking status. Non smoking was validated with carbon monoxide measurements in exhaled air. Patients who did not attend the follow-up visits were considered smokers. The number of participants at follow-up decreased significantly: from 70 subjects at visit one to 57 after 2 weeks, 34 at end of treatment and 14 subjects at months. Almost all (n = 69) were reached at 12 month by the phone. The validated quit rate after 12 months was 18.5% (13/70), 8 in group treated with nicotine patch and 5 in the group treated with bupropion SR (NS). When total group of smokers with newly diagnosed COPD was considered 10% quit smoking as result of minimal intervention with another 4.5% after pharmacological treatment.