An observational study of age-related smoking status in COPD patients stratified by severity of airflow obstruction

Abstract

Introduction: Smoking accelerates FEV1 decline in patients with COPD. Smoking cessation in earlier disease leads to a greater reduction in the rate of loss of FEV1 than in severe disease, so is particularly important and efficacious in younger patients and those with early disease. Aims and objectives: To quantify current smoking status in COPD patients stratified by age and severity of AFO (%predicted FEV1) in a UK General Practice population. Methods: Retrospective observational study, using individual patient-anonymised routine data held in the Hampshire Health Record (an electronic NHS database holding coded clinical data for over 1 million patients living in Hampshire, UK). Read codes (classification of clinical terms for electronic information coding) were used to identify a prevalent cohort with diagnosed COPD on 31/12/2010, smoking status and FEV1 %predicted. Results: Total cohort 16185 (male 54.5%) mean (SD) age 70.9 yrs (11.4); FEV1 %predicted recorded in 50% of patients: median (IQR) 59 (45-72). Smoking status in 96.2%: 37% current smokers, 57% ex-smokers, 3% never-smokers. In patients aged 65 yrs (p 75 yrs. Conclusions: While smoking cessation is important in all patients, we have been largely unsuccessful in younger patients with better preserved lung function, who have the greatest scope for improving their prognosis.