Smoking cessation and influenza vaccination can reduce the healthcare burden of COPD

Hui-Chuan Chang; Shih-Feng Liu; Ho-Chang Kuo; Kuang-Den Chen; Jui-Fang Liu; Ching-Wan Tseng; Ching-Mei Weng; Teng-Ching Chou

doi:10.18332/tid/167962

Smoking cessation and influenza vaccination can reduce the healthcare burden of COPD

Tob Induc Dis. 2023 Aug 26:21:108. doi: 10.18332/tid/167962. eCollection 2023.

Authors

Hui-Chuan Chang¹, Shih-Feng Liu^{1

2

3}, Ho-Chang Kuo^{1

3

4}, Kuang-Den Chen^{5

6}, Jui-Fang Liu^{7

8}, Ching-Wan Tseng¹, Ching-Mei Weng¹, Teng-Ching Chou¹

Affiliations

¹ Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
² Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
³ College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁵ Institute of Translation Research in Biomedicine, Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁶ College of Medicine, Chang Gung University, Kaohsiung, Taiwan.
⁷ Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan.
⁸ Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi, Taiwan.

Abstract

Introduction: Influenza vaccination (INV) and smoking cessation (SC) have individual positive effects on COPD, but their synergistic impact has yet to be extensively studied. This retrospective study aimed to assess the combined effect of SC and IV on the medical burden of COPD, including medical visits, hospitalization, medical expenses, and the occurrence of respiratory failure.

Methods: Patients with COPD who visited our medical center between January and October 2018 were included in the study. The patients were categorized into four groups: Group I (no SC or INV), Group II (INV only), Group III (SC only), and Group IV (both SC and INV). The outcomes analyzed were emergency utilization, hospital utilization, and occurrence of respiratory failure. Airflow limitation was stratified according to GOLD guidelines, and successful smoking cessation was defined as not smoking for at least one year.

Results: A total of 357 patients were included in the study. Group I (119 patients) neither smoking cessation nor influenza vaccination; Group II (66 patients) had only influenza vaccination; Group III (94 patients), had only smoking cessation, Group IV (78 patients), with both smoking cessation and influenza vaccination. Group IV had lower odds of emergency utilization (OR=0.13; 95% CI: 0.07-0.25), hospital utilization (OR=0.13; 95% CI: 0.05-0.30, p<0.001), and occurrence of respiratory failure (OR=0.13; 95% CI: 0.04-0.40, p<0.001).

Conclusions: Combined smoking cessation and influenza vaccination are more effective in reducing the medical burden of COPD compared to either intervention alone or neither. These findings highlight the importance of promoting both smoking cessation and influenza vaccination in the management of COPD.

Keywords: COPD; emergency utilization; hospital utilization; influenza vaccination; smoking cessation.