Neglecting the neglected: Tobacco cessation support is 'essential' for the management of asthma and COPD

Abstract

Introduction: Asthma and COPD management have a broad framework, and smoking cessation plays an essential role. We aimed to examine the management of asthma and COPD patients not only for inhaler treatment options but also for essential interventions, such as smoking cessation support.

Methods: Patients aged 18 and above who had been diagnosed with asthma or COPD for at least a year were included in the study. The demographic and clinical characteristics of the patients were investigated. Routine cessation interventions were implemented for current smokers, and they were followed via phone calls after one month regarding their quit status and access to cessation clinics.

Results: Data from 145 patients with asthma and 148 patients with COPD were analyzed. The rate of current smoking among the patients with asthma and COPD was 18.8% and 34.5%, respectively. According to asthma control test, 49% of asthma cases were poorly controlled and 34.4% of COPD patients were in Category E. Nearly all patients used inhaler therapy, and according to the guidelines, 45.2% of Category A and 72.7% of Category B COPD patients were overtreated with corticosteroid inhaler combinations. Among current smoker asthmatics 85.1% did not attempt to contact any quit line, and among current smoker COPD patients, 60.7% did not attempt to contact quit lines, and only 1.9% was admitted to a smoking cessation clinic during that one-month period. None of the current smokers had quit.

Conclusion: Tobacco cessation support seems to be neglected in asthma and COPD management. Instead, pulmonologists and the patients focus on pharmaceutical treatments, which constitute the other component of care.