Characteristics of and reasons for patients with chronic obstructive pulmonary disease to continue smoking, quit smoking, and switch to heated tobacco products

Kuniaki Hirai; Akihiko Tanaka; Tetsuya Homma; Tomoko Kawahara; Naruhito Oda; Hatsuko Mikuni; Yoshitaka Uchida; Haruhisa Saito; Yosuke Fukuda; Akiko Fujiwara; Yoko Sato; Tomoki Uno; Hideki Inoue; Shin Ohta; Fumihiro Yamaguchi; Shintaro Suzuki; Tsukasa Ohnishi; Hironori Sagara

doi:10.18332/tid/142848

Characteristics of and reasons for patients with chronic obstructive pulmonary disease to continue smoking, quit smoking, and switch to heated tobacco products

Tob Induc Dis. 2021 Nov 1:19:85. doi: 10.18332/tid/142848. eCollection 2021.

Authors

Kuniaki Hirai¹, Akihiko Tanaka¹, Tetsuya Homma¹, Tomoko Kawahara², Naruhito Oda², Hatsuko Mikuni³, Yoshitaka Uchida³, Haruhisa Saito³, Yosuke Fukuda⁴, Akiko Fujiwara⁵, Yoko Sato¹, Tomoki Uno¹, Hideki Inoue¹, Shin Ohta¹, Fumihiro Yamaguchi⁶, Shintaro Suzuki¹, Tsukasa Ohnishi¹, Hironori Sagara¹

Affiliations

¹ Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
² Division of Respiratory Medicine, Department of Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan.
³ Division of Respiratory Medicine, Department of Medicine, Kokuho Asahi Chuo Hospital, Chiba, Japan.
⁴ Division of Respiratory Medicine, Department of Medicine, Ebara Hospital, Tokyo, Japan.
⁵ Division of Respiratory Medicine, Department of Medicine, Odawara Municipal Hospital, Odawara, Japan.
⁶ Division of Respiratory Medicine, Department of Medicine, Showa University Fujigaoka Hospital, Fujigaoka, Japan.

Abstract

Introduction: Smoking is the leading cause of chronic obstructive pulmonary disease (COPD), and smoking cessation is the most effective treatment for patients with COPD. However, few studies have investigated the continuation/cessation of smoking and heated tobacco products (HTP) in patients with COPD. The objective of this study was to examine the characteristics of patients with COPD, those who are current smokers and those who switched from cigarettes to HTP, and to examine the reason for the continuation or cessation of smoking.

Methods: This multicenter, cross-sectional study included 411 outpatients with COPD. Data for this study were part of a study conducted for a comprehensive evaluation of the smoking status and clinical factors in patients with COPD and their families.

Results: Logistic regression analysis revealed that a younger age, longer duration of smoking, fewer daily cigarettes, and lower modified Medical Research Council (mMRC) dyspnea score, and a lower Simplified Nutritional Appetite Questionnaire (SNAQ) score for appetite, were characteristics of current smokers (age OR=0.94; duration of smoking OR=1.07; number of cigarettes per day OR=0.94; mMRC OR=0.68; SNAQ OR=0.83; p<0.05). The logistic regression analysis model showed that a younger age and higher education level were associated with the use of HTP (age OR=0.83; higher education level OR=4.63; p<0.05). Many of the current smokers displayed smoking behaviors that are not guaranteed to be safe, such as reducing smoking or switching to lighter cigarettes or HTP.

Conclusions: Patients with COPD who continue smoking tended to have low appetite as well as smoking behaviors that are not guaranteed to be safe. Physicians should provide appropriate guidance to these patients on smoking cessation.

Keywords: chronic obstructive pulmonary disease; cigarettes; heated tobacco products; smoking.