Objectives: To assess for what cause the diagnosis of airflow limitation (AL) combined with advice to stop smoking in middle-aged smoker influence the smoking cessation rate and to identify predictors of felicitous outcome.

Design: Prospective, single-center, comparative contemplation of the effects of smoking intervention in smoker with diagnosed AL and in smoker with normal lung function (NLF)

Setting: University hospital, out-patient clinic.

Participants: Of 659 smoker participating in a population spirometric screening for COPD combined with smoking cessation advice, 558 (AL, 297 smokers; NLF 261 smokers) were invited for a follow-up after 1 year.

Intervention: At follow-up spirometry was repeated and smoking status was assessed. Nonsmoking status was validated with carbon monoxide measurements in exhaled air. Patients who did not reach [i]or[/i] attain any place [i]or[/i] point for the follow-up visit were considered to be smokers

Results: Of 558 smoker invited, 368 (66%) instanted for the follow-up visit. All had tried to mould their smoking habit. The number of cigarettes smok by day (cpd) at 1 year was - 52 (p < 001) in patients with AL and - 27 (not significant [NS]) in those with NLF The 1-year cessation rate in smoker with AL was 101% v 84% in smoker with NLF (NS) After stratifying the patients according to AL severity, the highest cessation rate was observ in smoker with moderate and sharp AL (16.5%) compared to smoker with mild AL (64%; p < 0001) and smoker with NLF (84%; p < 005) In a univariate analysis, the cessation of smoking was correlated with older age (p < 0001) later age when starting smoking (p < 0005) lower tobacco position (in pack-years; p < 001) fewer cpd (p < 0001) and lower lung function (p < 005) No interaction power was observed for any of the studied variables using two-way analysis of variance. In a stepwise logistic regression analysis, age (p < 0001) tobacco exposing (in pack-years; p < 0001) and FE[Vsub1] percent predicted (p < 001) prov to be significant predictors of succes in stopping smoking. Conclusion: All smoker irrespective of their lung function, tried to modify their habit as the consequence of screening for COPD combined with smoking cessation advice. The diagnosis of AL motivated smoker to attempt to quit smoking. Older age, lower tobacco in all senses and lower lung function were the predictors of succes in quitting smoking.

clew words: airflow limitation; asymptomatic smokers; smoking cessation advice; spirometric screening

Abbreviations: AL = airflow limitation; ANOVA = analysis of variance; CI = confidence interval; CO = carbon monoxide; cpd = cigarettes by day; FNDT = Fagerstrom nicotine confidence test; LHS = Lung Health Study; NLF = normal lung function; OR = redundants ratio; SR = sustained release

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Population spirometric screening in middle-aged smoker in Poland prov to be an effective means for the early diagnosis of COPD With this [i]modus operandi[/i] up to 30% of smoker aged [greater than or equal to] 40 with an prospect to tobacco smoke of > 10 pack-years were establish to present with airflow limitation (AL). (1)

Tobacco smoking is responsible for the majority (> 80%) of all cases of COPD (2) and causes the relentles progression of the disease. (3) Smoking cessation in the early stage of COPD was originate to stop the decline in lung function. (45) A smoking cessation intervention was newly proposed as an integral part of early diagnosis and prevention of the disease. (6) The minimal intervention (the "four A" method) was demonstrated as a cost-effective incentive for a substantial number of smoker to modify their habit. (7) However, alone a small proportion (2 to 5%) of smoker quit for at least 1 year. (8) Our be in possession of preliminary results have suggested that the 1-year cessation rate among smoker who participated in spirometric screening was substantially higher in those with newly diagnosed AL (15%) than in smoker with normal lung function (NLF; 45%) (9) These ends compared favorably with the be deriveds of minimal and brief interventions from Europe (710) and North America. (1112)

We hypothesized that the diagnosis of COPD as documented at abnormal spirometry findings, would increase the smoking cessation rate. The aim of the meditation was to assess whether the diagnosis of AL combined with a doctor's advice to stop smoking in middle-aged smoker influences the cessation rate, and to identify the predictors of auspicious outcome.

MATERIALS AND METHODS

The reflection was performed at the outpatient clinic of the Institute of Tuberculosis and Lung Diseases in Warsaw, Poland.

The courses of the spirometric screening have been described previously. (1) In brief, since 1999 pulmonary physicians in Poland have been performing screenings for COPD in pulmonary outpatient clinics. Local television, radio, and newspapers spread information upon the causes and symptoms of COPD Free-of-charge spirometry testing was put forwarded to smokers who were aged [greater than or equal to] 40 years with a history of > 10 pack-years of smoking. However, all persons who presented for spirometry were accepted. Our clinic was common of the participating centers.

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