Research-Paper-On-Can-A-Smoking-Cessation-Program-Help-Adolescents-With-Copd-To-Quit-Smoking

Introduction

According to Andreas et al (2009), approximately 50% of older people who smoke are at high risk of being affected by chronic obstructive pulmonary disease (COPD). Similarly, 80% of deaths caused by COPD are related to smoking of tobacco. Despite the chronic symptoms that are exhibited by COPD patients, they often find it difficult to quit smoking. Professionals from 9 different medical societies under the umbrella of German Society of Pulmonology and Respiratory Medicine (Deutsche Gesellschaft fur Pneumologie und Beatmungsmedizin) have come up with an S3 smoking cessation guideline among patients suffering from COPD. In addition, they took into consideration the guidelines that had previously been published and more than 2000 formerly surveyed publications to come up with a new guideline in two consensus meetings which were followed by Delphi process. The study concluded that a smoking cessation combined with psychosocial support and medication is effective for patients with COPD.

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Smoking Cessation and COPD

Smoking cessation is effective in the improvement of the pulmonary functions, lowering COPD exacerbations, eliminating dyspnea and cough and lowering mortality rates. However, a mere reduction in smoking is not effective in improving pulmonary functions or even eliminating the symptoms. Therefore, smoking cessation has been determined to be the most effective and less expensive single method to reduce the risks of COPD and also curbing its progression. As such, it is best to encourage smoking cessation at every level of delivery of health care. Despite the fact that smoking cessation ranks amongst the most effective forms of dealing with the effects of COPD, the study found out that the German healthcare system has not accorded it the importance it deserves. In addition, the study also found out that almost a third of the German population smoke tobacco. Of these, a third of the females who smoke and half of the men who smoke are likely to consume 20 cigarettes in a day (Andreas et al, 2009).

Additionally, another study carried out by the European Union determined that the average age where individuals are most likely to take up smoking is between 13 and 14 (Fidler et al, 2006). Moreover, Germany has been identified as one of the countries with the highest rates of smoking. The vast majority of these smokers, about 80 to 90% would like to quit the habit in principle but due to the addictive characteristic of tobacco, they are unable to do so. 30% of those who smoke in Germany make at least one serious attempt to quit smoking in a period of 12 months. However, the success is only achieved in 5% among these attempts in the subsequent 12 months. As aforementioned, the habit of smoking tobacco is known to be the main risk factor in the development of chronic obstructive pulmonary disease (COPD).

Globally today, COPD is the fifth most prevalent cause of deaths while the trend shows that this is on the rise. According to a study carried out by West McNeill and Raw (2004), 8% to 13% of the adult population in both North America and Europe has been affected by COPD. Noteworthy, COPD leads to incurring of huge economic cost and is estimated to be 10 billion euros annually. Even with clinically manifest COPD, smoking cessation has positive outcomes on the patients. More importantly, many publications have been made to support the notion that smoking cessation is the most important means of dealing with COPD. As aforementioned, an S3 clinical guideline towards smoking cessation in patients with COPD has been formulated by the German Society for Pneumology and Respiratory Medicine. More importantly, the development of the guideline lasted between 2005 and early 2008. Interdisciplinary consensus and review of the available literature formed the basis of the guideline.

Besides Chronic obstructive pulmonary disease, pulmonary tuberculosis, lung cancer, and asthma are some of the most common pulmonary disorders that are caused or worsened by the smoking of tobacco. However, a growing range of evidence suggests that the prognosis and symptoms of these diseases improved when one adopts smoking cessation. According to Jimenez-Ruiz et al (2015), a study was carried out to find out the effectiveness of smoking cessation on improving COPD. The study found out that despite the fact that there is growing evidence that smoking cessation is very effective in the treatment of the patients suffering from a wide range of pulmonary diseases, there is still little evidence to show that the patients are subjected to the treatment. As such, most of them continue smoking and hence enhancing the rates of COPD. The study adopted a qualitative approach to examine the effectiveness of smoking cessation in patients with COPD and other pulmonary disorders.

According to Fiore and Baker (2011), a group of European Respiratory Society professionals published the result of a study aimed at finding how smoking cessation can be used to treat patients with COPD. The study described the epidemiological relationship between tobacco smoking and pulmonary diseases. In addition, it aimed at looking at the benefits of quitting smoking, the most appropriate way to assess the dependence on tobacco and the current best practices that can be employed to assist the patients of COPD to quit smoking. Moreover, the study also described the most common characteristics of hardcore smokers and how they can be managed since this group finds it very difficult to quit smoking under normal circumstances. The study included a review of narratives sourced from the published studies. The study found out that a higher level of nicotine hindered the efforts of individuals to quit smoking. But the most important conclusion from the study was that patients suffering from COPD are in urgent need to employ the use of smoking cessation.

In addition, several studies have postulated that it is important to integrate smoking cessation programs with other approaches. For instance, the programs work best when combined with therapies that include pharmacological treatment which includes nicotine replacement therapy (NRT). In addition, it is pivotal to integrate these with behavioral support. Noteworthy, it is also important for the respiratory physicians to receive intense training so that they can have the knowledge, attitudes, and skills necessary to effectively assist patients with COPD or refer them to the appropriate physician. Although a reduction in attendance for exacerbations helps to reduce the cost of implementation of these recommendations, a budget is required to ensure effective implementation of the smoking cessation programs. In the recent past, the ERC in association with UK Centre for Tobacco and Alcohol Studies creates the SmokeHaz website. The attempts were to continue with the efforts of the European Lung Foundation which aimed at developing a website dedicated totally to providing information on pulmonary diseases and smoking.

How Smoking Causes COPD

COPD is a multisystem and progressive disease whose main symptom is the limitation in airflow. In addition, it has been identified as one of the most common respiratory disorders affecting between 8% and 13% of the population in North America and Europe but still many of the cases go undiagnosed (Chaudhuri et al, 2006). Additionally, the prevalence of the disease is on the rise and also increases with age. More importantly, a strong relationship exists between smoking and the prevalence of COPD. For instance, 40% of those who suffer from COPD are either smokers or ex-smokers. Epidemiological studies suggest that smoking causes a deterioration of the pulmonary activities. Similarly, when one smokes at an adolescent age, the normal expansion expected of the pulmonary activities is inhibited. As a result, such individuals are at high risk of developing forced expiratory volume in 1 s (FEV1) in old age. In other words, when one smokes, the age at which forced expiratory volume begins is lowered. Similarly, in late adulthood, the annual decrease of FEV becomes enhanced.

Recently, a British study showed that when one smoke even a single cigarette at the age of 11, there is a double adjusted relative risk that he/she will adopt smoking 3 years later. Therefore, this is proof of the level of addiction to nicotine, especially in adolescents. In principle, 80% to 90% of those who smoke want to quit. However, among them, only 30% make a serious attempt within 12 months and the attempts become unsuccessful in less than 5% of them if they do not get support. The reason behind this is that when nicotine is inhaled in cigarettes, it has the characteristic of a highly addictive drug. The smoke from cigarettes forms part of the heterogeneous aerosols that contains more than 4000 substances that come out when tobacco is incompletely burnt. The result is that it triggers humoral immune and cellular responses which create a variety of respiratory and systematic infections.

Noteworthy, smokers who are suffering from COPD bear certain unique characteristics. In addition, it is these unique features that make it difficult for them to quit smoking. In two separate studies that were recent carries out, it was reported that patients with COPD recorded a higher number of cigarettes smoked daily as well as on Fagerstrom Test for Nicotine Dependence (FTND) as compared to the smokers without COPD (Eisner et al, 2000). Similarly, it was established that with an additional point in FTND, the chances of getting COPD increases by 11%. In general,, therefore, the studies suggest that those suffering from COPD are more dependent on nicotine than those who do not. Conversely, individuals whose rates of dependence on nicotine is higher are at a higher risk of developing COPD. More importantly, many studies have postulated that smokers who are suffering from COPD inhale much more smoke and inhale deeper than those who do not have COPD. In other words, more toxic materials access the lungs of smokers with COPD than those who do not have.

In support of the above notion, a study also found that patients of COPD had more expired carbon monoxide in their lungs than those who do not suffer from COPD. However, some studies have reported finding no significant link between the motivation to quit between COPD patients who smoke and other smokers. Nevertheless, smokers suffering from COPD exhibit low self-esteem and self-efficacy which inhibits their ability to quit smoking. Additionally, 44% of patients with COPD have a higher chance of suffering from depression and at the same time, depression is common among smokers with COPD as compared to other smokers. Therefore, a vicious circle exists when it comes to the issue of smoking causing COPD as well as COPD causing depression. Noteworthy, depression has a negative impact on the attempts of smokers with COPD to quit smoking.

The Use of Smoking Cessation

All over the world, smoking cessation remains the most pivotal method to reduce the decline in lung function in patients suffering from COPD. The reason behind this is that it lowers the annual decrease in FEV1 up to the level that is similar to those of non-smokers. Initially, FEV1 is known to increase after smoking cessation process and those who quit exhibiting a good response to inhaled corticosteroids (ICS) and bronchodilators. A multicenter interventional study of bronchodilator therapy carried out in the recent past established that 40% of those who were sampled having severe to moderate COPD...