Severe exacerbations trigger towards a first smoking cessation attempt: a nationwide cohort study

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Introduction: Smoking prevention and cessation have proven to be the most effective non-pharmacological intervention to tackle poor outcomes in asthma and COPD. Aims: To investigate whether respiratory symptomatic patients who smoke tobacco have specific moments when they are more receptive to behavioural change, and which health events or diagnoses could create treatable moments for nicotine dependence to facilitate a first smoking cessation attempt. Methods: In Belgian patients aged ≥18 years who chronically used medication for obstructive lung diseases between 2017-2022 and who were currently smoking tobacco, the impact of potential triggering events on initiating a first smoking cessation attempt was assessed by multivariable Cox proportional hazards models. Results: Among 78,452 chronic users of pulmonary medication (median age 63 years, 49% female), 8,822 (11.2%) patients attempted smoking cessation. A severe exacerbation provided the greatest opportunity (aHR 1.73, 95%CI 1.63-1.83) for a first smoking cessation attempt, followed by alcoholism registration (aHR 1.70, 95%CI 1.61-1.80), antidepressant use (aHR 1.63, 95%CI 1.56-1.71) and acute myocardial infarction (aHR 1.50, 95%CI 1.35-1.66). erj;66/suppl_69/PA3760/F1 F1 F1 Conclusions: This large real-life cohort study among asthma and COPD patients highlights that exacerbations resulting in hospitalization provide an important treatable moment to initiate smoking cessation.

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