Journal of General Internal Medicine

, Volume 24, Issue 4, pp 457–463

The Effects of Smoking Cessation on the Risk of Chronic Obstructive Pulmonary Disease Exacerbations

  • David H. Au
  • Christopher L. Bryson
  • Jason W. Chien
  • Haili Sun
  • Edmunds M. Udris
  • Laura E. Evans
  • Katharine A. Bradley
Original Article

DOI: 10.1007/s11606-009-0907-y

Cite this article as:
Au, D.H., Bryson, C.L., Chien, J.W. et al. J GEN INTERN MED (2009) 24: 457. doi:10.1007/s11606-009-0907-y

Abstract

BACKGROUND

Smoking cessation has been demonstrated to reduce the rate of loss of lung function and mortality among patients with mild to moderate chronic obstructive pulmonary disease (COPD). There is a paucity of evidence about the effects of smoking cessation on the risk of COPD exacerbations.

OBJECTIVE

We sought to examine whether smoking status and the duration of abstinence from tobacco smoke is associated with a decreased risk of COPD exacerbations.

DESIGN

We assessed current smoking status and duration of smoking abstinence by self-report. Our primary outcome was either an inpatient or outpatient COPD exacerbation. We used Cox regression to estimate the risk of COPD exacerbation associated with smoking status and duration of smoking cessation.

PARTICIPANTS

We performed a cohort study of 23,971 veterans who were current and past smokers and had been seen in one of seven Department of Veterans Affairs (VA) primary care clinics throughout the US.

MEASUREMENTS AND MAIN RESULTS

In comparison to current smokers, ex-smokers had a significantly reduced risk of COPD exacerbation after adjusting for age, comorbidity, markers of COPD severity and socio-economic status (adjusted HR 0.78, 95% CI 0.75–0.87). The magnitude of the reduced risk was dependent on the duration of smoking abstinence (adjusted HR: quit <1 year, 1.04; 95% CI 0.87–1.26; 1–5 years 0.93, 95% CI 0.79–1.08; 5–10 years 0.84, 95% CI 0.70–1.00; ≥10 years 0.65, 95% CI 0.58–0.74; linear trend <0.001).

CONCLUSIONS

Smoking cessation is associated with a reduced risk of COPD exacerbations, and the described reduction is dependent upon the duration of abstinence.

KEY WORDS

chronic obstructive pulmonary disease exacerbation smoking cessation 

Copyright information

© Society of General Internal Medicine 2009

Authors and Affiliations

  • David H. Au
    • 1
    • 2
  • Christopher L. Bryson
    • 1
    • 2
  • Jason W. Chien
    • 2
    • 3
  • Haili Sun
    • 1
  • Edmunds M. Udris
    • 1
  • Laura E. Evans
    • 4
  • Katharine A. Bradley
    • 1
    • 2
  1. 1.Health Services Research and DevelopmentVA Puget Sound Health Care SystemSeattleUSA
  2. 2.Department of MedicineUniversity of WashingtonSeattleUSA
  3. 3.Clinical Research DivisionFred Hutchinson Cancer Research CenterSeattleUSA
  4. 4.Department of MedicineNew York UniversityNew YorkUSA

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