Smoking prevalence, behaviours, and cessation among individuals with COPD or asthma

Smoking prevalence, behaviours, physician counselling regarding smoking cessation, and smoking cessation medications were evaluated among male and female smokers with COPD and asthma compared to the general smoking population.

Data from the large, nationally representative Canadian Community Health Survey (CCHS) was used (for 2003 CCHS, n = 134,072). All data were based on self-report, including the presence of COPD and asthma which were defined by health-professional diagnosis. Nicotine addiction was assessed by the Fagerstrom Test for Nicotine Dependence.

In 2003, 32.8% of individuals with COPD, 21.0% with asthma, and 22.1% without COPD or asthma were current smokers. After adjusting for sociodemographic and smoking behaviour confounders, among current smokers, greater odds of high or very high nicotine addiction were observed among women with versus without COPD (OR = 2.49, 95% CI = 1.41-4.39), and among women with versus without asthma (OR = 1.74, 95% CI = 1.01-2.99), but no associations were seen among men. Smokers with COPD and asthma were no more likely to have received physician counselling regarding smoking cessation, nor smoking cessation pharmacotherapy compared to the general smoking population.

Gender differences were observed in the association between COPD and asthma and higher nicotine addition levels in current smokers. These findings could in part explain population trends showing that COPD and asthma are increasing more rapidly in women. Physician counselling and pharmacotherapy for smoking cessation do not appear to be received more frequently among individuals with COPD or asthma compared to the general smoking population, despite the greater vulnerability of such patients to smoking effects.