The effect of a minimal contact smoking cessation programme in out-patients with chronic obstructive pulmonary disease: a pre-post-test study

This study assessed the efficacy of an individual, minimal contact, smoking cessation programme in chronic obstructive pulmonary disease (COPD) patients, using a pre-post-test design. The study was part of a large ongoing investigation into the efficacy of self-management in patients with COPD (the COPE-study). In total, the participants received three 15-30 min home-based counselling sessions. Additionally, patients were provided with a written self-help manual. On the patient's request, the chest physician prescribed bupropion or nicotine replacement therapy (NRT). Cessation rates after nine months were based on self-report, and afterwards confirmed by salivary cotinine analysis. Patients were biochemically classified as smoker if their cotinine levels exceeded 20 ng/ml. At baseline, one third of the 269 patients in the COPE-study were active smokers (according to self-report). Almost 70% (n = 64) of these patients were willing to participate in the smoking cessation program. After nine months follow-up, 23 (36.5%) patients self-reported abstinence. However, the cotinine validated abstinence rate was much lower: 12.7% (n = 8), implying that the actual abstinence rate is severely overestimated by self-report in this study. The results suggest that the (validated) effectiveness of this intervention is probably in line with that: of comparable programmes for healthy persons. However, considering the urgent need for quitting in COPD patients, a more intensive programme resulting in higher quit rates, seems to be required for this high-risk population. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.