Guideline on medical care for patients with chronic obstructive pulmonary disease and other lung obstructive diseases during tobacco smoking withdrawal

Abstract

Morbidity of chronic obstructive pulmonary disease (COPD) is consistently increasing last decades in Russian Federation. Similarly, the total morbidity is also increasing together with annual healthcare costs. The main risk factor of COPD is tobacco smoking. Therefore, the encouragement of smokers to quit smoking and medical care for nicotine withdrawal should be considered as main factors to control COPD morbidity. Bronchial hyperreactivity could occur early in smokers and COPD could develop in smokers with longer smoking history. Mild to moderate COPD is diagnosed in > 20% of smokers seeking medical aid for nicotine withdrawal. Typically, bronchial hyperreactivity becomes worse after quitting the smoking. This should be considered by a physician and long-acting bronchodilators should be used during nicotine withdrawal. Therefore, an individual plan is necessary for every smoking patient with COPD including quitting the smoking with consideration the severity of nicotine dependence and motivation to quit smoking. The individual plan should also include initiation or optimisation of bronchodilator therapy to prevent worsening of bronchial hyperreactivity. Quitting the smoking is the most effective intervention to slow COPD progression.