Smoking while living with chronic obstructive pulmonary disease? Learn about strategies to help you quit!

The Bottom Line

  • If you are living with chronic obstructive pulmonary disease (COPD) and smoke, quitting smoking is crucial to help you improve your symptoms, health, and quality of life.
  • Combining behavioural treatments with drug treatments may be the best strategy to help you quit.
  • Talk to your healthcare team about what combination of strategies may be best for you.

Are you living with chronic obstructive pulmonary disease (COPD) and still smoking, but interested in quitting? Research shows quitting smoking, no matter how long you have been smoking, can have important benefits for your health, even with COPD (1-3).


COPD is a lung disease that results in breathing problems. As of 2020, it is estimated that over 830,000 people are living with the disease in Canada (2). People with COPD may cough a lot, wheeze, have a hard time breathing, and feel tired. Smoking and air pollution are the two most common causes of COPD (1). While unfortunately there is no cure for COPD, quitting smoking can help to improve symptoms and quality of life, and help you live longer (1-3).


It can be hard to quit smoking, but doing so can change your life! Common methods to try and quit include drug treatments, such as nicotine replacement therapy (NRT), bupropion, and varenicline, behavioural treatments, such as cognitive behavioural therapy [CBT] or counselling, or a mix of both. But which methods are best?


A recent systematic review helps answer this question by looking at the effectiveness of such strategies in helping people living with COPD quit smoking compared to placebo or usual care (2).


What the research tells us

Overall, the review found that most behavioural treatments and drug treatments may be effective in helping people with COPD quit smoking. Single therapies like CBT, NRT, and varenicline are amongst those that show benefits.


However, research shows that some strategies may be better than others when you are trying to quit smoking. More specifically, combining two strategies is found to be more effective than using any one therapy alone. The most effective combinations may be cognitive behavioural therapy and bupropion, followed by counselling and varenicline.


The authors of the review note that more high-quality research is needed on the topic, as most of the included studies are of low or unclear quality. Additionally, more research is needed on the safety of drug treatments. That said, a few studies did report that the drug treatments varenicline, bupropion, and nicotine replacement therapy may come with negative side effects including insomnia, dry mouth, cardiac-related side effects, and general discomfort. Fortunately, all other treatments looked at, including behavioural treatments, are deemed to be generally safe (2).


If you are living with COPD and are ready to take steps towards quitting smoking or want to learn more, talk to your healthcare team about the different strategies and combinations that exist and that are optimal for you and your needs.


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References

  1. World Health Organization. Chronic obstructive pulmonary disease (COPD). [Internet] 2023. [cited July 2023]. Available from https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
  2. Wei X, Guo K, Shang X, et al. Effects of different interventions on smoking cessation in chronic obstructive pulmonary disease patients: A systematic review and network meta-analysis. Int J Nurse Stud. 2022; 136:104362. doi: 10.1016/j.ijnurstu.2022.104362.
  3. Abu Hassan H, Abd Aziz N, Hassan Y, et al. 2014. Does the duration of smoking cessation have an impact on hospital admission and health-related quality of life amongst COPD patients? Int J Chron Obstruct Pulmon Dis Pulmon Dis. 9:493-498. doi: 10.2147/COPD.S56637. 
  4. Statistics Canada. Chronic obstructive pulmonary disease (COPD), 35 years and over. [Internet] 2022. [cited July 2023]. Available from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310009619.

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