Persistent smoking by Japanese patients within four years from diagnosis of chronic obstructive pulmonary disease

This study ascertained the smoking prevalence and factors affecting continuous smoking by Japanese patients within four years from diagnosis of chronic obstructive pulmonary disease (COPD). Of the 300 patients referred from six hospitals in central Japan, 276 eligible participants (mean age 66.5 years, SD 6.7) were interviewed for their habitual cigarette consumption. Overall, 22.5% of patients were current smokers but the prevalence appeared to decrease from <1 year (24.5%) to 2-4 years (19%) after diagnosis. They had smoked on average for 41 (SD 11) years and 89% of the current smokers smoked daily. Continuous smoking was inversely associated with age (odds ratio (OR)=0.94, 95% CI 0.90-0.98), body mass index (OR=0.88, 95% CI 0.80-0.97) and disease severity (OR=0.29, 95% CI 0.12-0.74 for severe COPD and OR=0.29, 95% CI 0.09-0.92 for very severe COPD). It is alarming to find mild and moderate COPD patients continue to smoke. The implementation of a co-ordinated tobacco control program immediately post diagnosis is needed for the effective pulmonary rehabilitation of COPD patients.