Department of General Practice, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Respir Med. 2011 Feb;105(2):243-9. doi: 10.1016/j.rmed.2010.07.010. Epub 2010 Sep 17.
Case-finding of chronic obstructive pulmonary disease (COPD) using spirometry may deter people with normal lung function from stopping smoking. The objective of this study was to observe the percentage of smokers screened with normal lung function that quit smoking.
As part of a study on early detection of COPD, 518 smokers were screened with normal lung function (post-bronchodilator FEV(1)/FVC ≥ 70%). They were invited for a follow-up measurement after an average of 2.4 years. Non-smoking was validated by carbon monoxide (<10 ppm), and respiratory health related quality of life was measured with the Clinical COPD Questionnaire (CCQ).
A total of 255 participants were followed up (49%). The point prevalence rate of non-smoking at follow-up was 18% (N = 47), and 9% assuming that all non-respondents were smokers. This rate was not lower than the expected rate of quitting in the Dutch population (8-9%) and primary "care as usual" in smokers screened with abnormal lung function (10%; p > 0.05 for all comparisons). The average decline in post-bronchodilator FEV(1) was 26 mL/year, which was unrelated to smoking status at follow-up. Non-smokers showed a clinically meaningful and statistically significant (p < 0.001) improvement in CCQ respiratory symptoms (-0.96) and total score (-0.51).
Our results do not suggest that early detection of airflow limitation to motivate smoking cessation reduces the rate of quitting in smokers shown to have normal lung function. Such smokers should be advised to quit smoking on the grounds that they are likely to improve their respiratory health in the short term and reduce their risk for smoking related diseases in the long term.
使用肺活量测定法对慢性阻塞性肺疾病（COPD）进行病例发现可能会阻止肺功能正常的人戒烟。本研究的目的是观察肺功能正常的吸烟者戒烟的比例。
作为 COPD 早期检测研究的一部分，对 518 名肺功能正常（支气管扩张剂后 FEV1/FVC≥70%）的吸烟者进行了筛查。平均 2.4 年后，邀请他们进行随访测量。通过一氧化碳（<10ppm）验证不吸烟，通过临床 COPD 问卷（CCQ）测量呼吸健康相关的生活质量。
共有 255 名参与者（49%）接受了随访。随访时非吸烟者的点患病率为 18%（N=47），假设所有未应答者均为吸烟者，则为 9%。这一比率并不低于荷兰人群预期的戒烟率（8-9%），也不低于在肺功能异常的吸烟者中进行常规“初级护理”的戒烟率（10%；所有比较均为 p>0.05）。支气管扩张剂后 FEV1 的平均下降量为 26mL/年，与随访时的吸烟状况无关。非吸烟者的 CCQ 呼吸症状（-0.96）和总分（-0.51）均有显著改善（p<0.001）。
我们的结果表明，早期发现气流受限以促使戒烟并不能降低肺功能正常的吸烟者的戒烟率。对于这些吸烟者，应该建议他们戒烟，因为他们在短期内可能会改善呼吸健康，并降低长期吸烟相关疾病的风险。
