Certified Smoking Cessation Units in Spain: High Potential for Detection of Undiagnosed Chronic Obstructive Pulmonary Disease and Profile of Newly Diagnosed Cases

Abstract

Juan-Antonio Riesco-Miranda,1,2 Segismundo Solano-Reina,3 Carlos Rábade-Castedo,4 José-Ignacio de Granda-Orive,5 Esther Pastor-Esplá,6 Marcos García-Rueda,7 Francisco-Javier Callejas-Gonzalez,8 Ángel Azpeitia-Anadón,9 Silvia Mas,10 Carlos-Andrés Jiménez-Ruiz11 1Servicio de Neumología, Hospital Universitario de Cáceres, Cáceres, Spain; 2CIBERES, Madrid, Spain; 3Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; 4Servicio de Neumología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; 5Servicio de Neumología, Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid, Madrid, Spain; 6Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain; 7Servicio de Neumología, Hospital Universitario Carlos Haya, Málaga, Spain; 8Servicio de Neumología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain; 9Departamento Médico Labs, Esteve S.A, Barcelona, Spain; 10Universidad Pompeu Fabra, Barcelona, Spain; 11Unidad Especializada de Tabaquismo, Hospital Clínico Universitario, Madrid, SpainCorrespondence: Silvia MasUniversitat Pompeu Fabra, Campus Poble Nou, Roc Boronat 138, Barcelona, 08018, SpainEmail [email protected]: Smokers attending smoking cessation units (SCUs) may offer a unique opportunity for early recognition of undiagnosed chronic obstructive pulmonary disease (COPD). We aimed at assessing the impact of SCUs on the early diagnosis of COPD and describing the clinical and smoking profile of newly-diagnosed COPD cases at SCUs certified by the Spanish Society of Respiratory Diseases and Thoracic Surgery (SEPAR).Patients and Methods: A multicenter cross-sectional observational cohort study (DIPREPOQ study) was performed in eight SEPAR-certified SCUs in Spain. Adult current smokers with no previously diagnosed respiratory disease and having one o more respiratory symptoms were included. Lung functional tests were performed and previously undiagnosed COPD cases were identified and characterized based on national guidelines.Results: Out of 401 individuals newly attending the SCUs, 252 participants were included and 73 (28.9%) met the definition of previously undiagnosed COPD. A characterization of patients with COPD being newly recognized in SCUs showed: age (mean±SD) 61± 9 years; men 59%; active work status 53.1%; functional class I/II dyspnea 82.8%, GOLD state mild/moderate/severe 57%/31%/12%; non-exacerbators 90%, CAT 14± 4; emphysema in X-rays 40%. Most common co-morbidities were cardiovascular and psychiatric (anxiety and depression) ones. Usual smoking history included a lengthy smoking history (41± 9 years) and a current consumption of 24± 9 cigarettes/day.Conclusions and Implications: Consistently certified SCUs can have a substantial contribution to early diagnosis of COPD. A typical profile of newly detected cases is reported, with most patients being men at their early sixties, with mild symptoms and with high and lengthy smoking history. Our study reports a high usefulness of lung functional tests to detect undiagnosed COPD in appropriately selected participants attending SCUs at a large national scale, using a standardized methodology. This is likely to be facilitated by the certification of SCUs using well-defined requirements by national scientific societies.Keywords: health consequences, smoking, chronic obstructive pulmonary disease, smoking cessation unit

Keywords

• health consequences
• smoking
• chronic obstructive pulmonary disease
• smoking cessation unit