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KMID : 1146320190070020103
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Journal of Health Technology Assessment
2019 Volume.7 No. 2 p.103 ~ p.111
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The Effect of Smoking Cessation Interventions in Patientswith Chronic Obstructive Pulmonary Disease: A Systematic Review
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Lee Bo-Ram
Jang Su-Hyun
Choi Na-Hye
Lee Young-Sil
Cheong Che-Lim
Lee Tae-Jin
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Abstract
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Objectives: The prevalence of chronic obstructive pulmonary disease (COPD) is expected to rise in not only developed countries, but also developing countries. Smoking is the largest risk factor for COPD and smoking cessation is the most effective way to prevent or slow the progression of the disease. In this study, we reviewed literatures to investigate the benefits of smoking cessation interventions in COPD patients.
Methods: A systematic literature search was performed based on patient, intervention, comparison, outcomes framework. The main searching terms were COPD, emphysema, bronchitis, pulmonary disease, and smoking cessation in PubMed, EMBASE, Cochrane library, KoreaMed, and RISS. The participants were current adult smokers with COPD. We included smoking cessation counselling/education, drugs (varenicline, bupropion), and nicotine replacement treatment as interventions but excluded cases where the intervention was only a part of disease management program. The comparisons were no treatment, usual care, or placebo. The outcomes were abstaining rate, forced expiratory volume in one second (FEV1) decline rate, and mortality. The follow-up time of study was at least 6 months. We included randomized/non-randomized controlled trials (RCT/nRCT), and cohort studies written in English or Korean. Authors independently extracted the data and resolved any disagreements by consensus.
Results: The sixteen published articles (12 studies) were selected; 11 RCTs and 1 nRCT. We found consistent evidences that such interventions were very supportive to help COPD patients quit smoking. Also abstinent COPD patients in the intervention group showed better health outcomes than those in the control group in terms of FEV1 decline rate and all-cause mortality.
Conclusion: Smoking cessation interventions are effective to reduce lung function decline rate and mortality by encouraging COPD patients to stop smoking.
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KEYWORD
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Chronic obstructive pulmonary disease, Smoking cessation, Systematic review
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