HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Godtfredsen, N. S. Articles by Vestbo, J. PubMed PubMed Citation Articles by Godtfredsen, N. S. Articles by Vestbo, J.

COPD-related morbidity and mortality after smoking cessation: status of the evidence

¹ Copenhagen Centre for Prospective Population Studies, Institute of Preventive Medicine, ² Dept of Cardiology and Respiratory Medicine, Hvidovre Hospital and Faculty of Health Sciences, University of Copenhagen, and ⁹ Dept of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark. ³ Dept of Community Medicine, School of Public Health, University of Hong Kong, Pokfulam, Hong Kong. ⁴ National Heart and Lung Institute, Imperial College, London, and ¹⁰ North West Lung Centre, Wythenshawe Hospital, Manchester, UK. ⁵ International Agency for Research on Cancer, Lyon, France. ⁶ Cancer Council, Victoria, Australia. ⁷ Arkansas Dept of Health, Little Rock, AR, and ⁸ School of Medicine, University of California at San Diego, San Diego, CA, USA.

CORRESPONDENCE: N. S. Godtfredsen, Dept of Respiratory Medicine, Bispebjerg Hospital, DK-2400 Copenhagen NV, Denmark. Fax: 45 35312865. E-mail: ngod0001{at}bbh.regionh.dk

Keywords: Chronic obstructive pulmonary disease, morbidity, mortality, review, smoking cessation

Received: November 27, 2007
Accepted May 25, 2008

The evidence base for the benefit of quitting smoking as regards morbidity and mortality outcomes in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) is limited.

The present article is a review of the existing literature. A systematic literature search in medical databases was performed until March 2006, and subsequently until September 1, 2007. The outcomes examined were COPD-related morbidity and mortality (including all-cause mortality) in COPD patients in connection with smoking cessation.

A total of 21 and 27 published articles on morbidity and mortality, respectively, were identified and reviewed. For both outcomes, only a few of the studies included patients with severe COPD. Most of the studies reported a beneficial effect of smoking cessation compared with continued smoking, whereas a few found no improvement. Methodological problems, including small study sizes, poor data quality, possibility of reverse causality and incomplete ascertainment of cause of death, limit interpretation of some of the studies.

The evidence as a whole supports the conclusion that, even in severe chronic obstructive pulmonary disease, smoking cessation slows the accelerated rate of lung function decline and improves survival compared with continued smoking.