Prevent Emphysema Now!
Information for Physicians on the Diagnosis and Treatment of COPD
Smoking cessation has been proven to improve lung function and to increase life span. It has also been shown to lessen the risk of heart attack and stroke, and, after years of no smoking, the risk of lung cancer declines. A practical method in smoking cessation is briefly presented below (Table 3) and discussed further on the next page.
The most important stop-smoking intervention is serious counseling about the importance of stopping smoking and the development of a cessation plan. Picking a quit date is key. Nicotine replacement should be started on the quit date. Nicotine replacement products available over-the-counter or by prescription are listed in Table 3.
The non-nicotine product, bupropion, is at least as effective as nicotine replacement in smoking cessation. When nicotine replacement and bupropion are used together, up to a 35.5% biologically proven quit rate can be achieved at one year, compared to a 15.6% success rate with no pharmacologic interventions. When medication is successful, cessation usually occurs within two weeks. Re-treatment is appropriate up to seven or eight times for those who fail. Start bupropion two weeks before quit date to help insure success in quitting.
The retardation of decline in FEV1 over 30 years has been demonstrated (see Figure 4). Even patients who stopped smoking at age 65 had a survival benefit. Thus, it is never too Iate to stop smoking, but it is far better to stop at a young age and before advanced emphysema develops.
From: Peto R, Speizer FE, Cochrane AL, Moore F, Fletcher CM, Tinker CM, et al: The relevance in adults of air-flow obstruction, but not of mucus hypersecretion, to mortality from chronic lung disease. Results from 20 years of prospective observation. Am Rev Respir Dis 1983;128:492.