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14-09-2009 | Respiratory | Article

Counseling and NRT best for smoking cessation in COPD patients


Free abstract

MedWire News: Counseling combined with nicotine replacement therapy (NRT) is the most effective smoking cessation intervention for patients with chronic obstructive pulmonary disease (COPD), findings from a meta-analysis suggest.

“Smoking cessation is the single most important intervention to prevent COPD or to reduce its progression,” write Milo Puhan (Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA) and colleagues in the European Respiratory Journal.

However, they add that the most effective intervention for helping COPD patients quit smoking has not been identified.

To investigate, the researchers searched Medline and other literature databases for randomized trials of smoking cessation counseling (SCC) with or without pharmacotherapy or NRT.

In total, eight studies involving 7477 COPD patients were included in the final analysis.

The researchers found that six of the studies showed that SCC in combination with NRT had the greatest effect on prolonged abstinence rates in COPD patients. Indeed, compared with patients who were not assigned to a smoking cessation program (usual care), those who received SCC plus NRT were 5.08 times more likely to remain abstinent.

The second most effective intervention was SCC plus an antidepressant, increasing the chances of abstinence 3.32-fold compared with usual care, with no difference between antidepressants.

SCC alone only slightly increased the chances of prolonged abstinence compared with usual care, at an odds ratio of 1.81.

Puhan and team conclude: “A small body of evidence suggests that SCC combined with NRT is more effective than other combinations and single smoking cessation treatments in COPD.

“However, a much larger research effort is required to further enhance the effectiveness of smoking cessation strategies as the most important single intervention for COPD patients.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

By Mark Cowen

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