Chapter

Smoking cessation and lung disease and COPD

Carlos A. Jiménez-Ruiz

in Smoking Cessation

Published on behalf of Oxford University Press

ISBN: 9780199556250
Published online May 2011 | e-ISBN: 9780199607327 | DOI: http://dx.doi.org/10.1093/med/9780199556250.003.0006

Series: Oxford Respiratory Medicine Library

Smoking cessation and lung disease and COPD

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• Smoking cessation should be an integral part of lung disease treatment. • Smokers with lung disorders can have specific smoking characteristics that make it difficult for them to quit: higher nicotine dependence, lower self-efficacy, depression, weight gain problems, fatalistic beliefs, and emotional distress. • Positive advice delivered opportunistically during routine consultations to respiratory patients who smoke, using ‘teachable moments’, is effective to help them to quit and so should always be provided. • NRT is efficacious and safe for helping pulmonary patients who smoke to quit. However, higher doses are often needed, often combining different forms, for prolonged duration. NRT is also used to help smokers with chronic obstructive pulmonary disease (COPD) to reduce the number of cigarettes smoked as a gateway to quitting. • Bupropion is significantly more effective than placebo in smokers with COPD, at least over 6 months There is no increase in the number or intensity of adverse effects associated with taking bupropion in COPD patients compared to other groups. • Nortriptyline can be an useful alternative for the treatment of smokers with COPD when first-line medications have failed. • Results using varenicline in COPD patients are awaited; initial experience suggests it is well-tolerated and useful.

Chapter.  2079 words.  Illustrated.

Subjects: Respiratory Medicine and Pulmonology

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