Differences in Smoking Behaviors and Readiness to Change for Patients with COPD and Differing Categories of Depression

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world. Depression is a common comorbidity of COPD and affects patient outcomes and smoking cessation. The purpose of this study was to explore and describe factors influencing smoking behaviors and readiness to change in patients with comorbid COPD and depression. Aims: The research question that guided this study was, “What are the relationships among smoking, COPD, and depression?” The following aims stemmed from the research question: to describe the characteristics of a convenience sample of people living with COPD and differing categories of depression who sought care in West Virginia; to describe the differences between people with COPD and differing categories of depression (minimal, mild, moderate, moderately severe, severe, or no depression) related to smoking behaviors and readiness to change; to explore the relationships among COPD, depression, smoking behaviors, and readiness to change; and to analyze the relationships among COPD, depression, smoking behaviors, and readiness to change. Methods: A descriptive cross-sectional design was used. A convenience sample of 222 COPD patients participated in the study. COPD was self-reported. Depression was assessed through the PHQ-9. Smoking behaviors were assessed through The Cigarette Dependence Scale. Readiness to change was assessed through The Smoking Stage of Change Questionnaire, The Smoking Decisional Balance Questionnaire, and The Processes of Change Questionnaire. Electronic and paper questionnaires were collected using various recruitment strategies. Data was stored in RedCap and analyzed using SPSS version 26. Descriptive analyses were conducted and ANOVA, t-test, chi-square, Pearson correlation, linear regression, and multiple linear regression were used to analyze the relationships among smoking, COPD, and depression. Results: Most participants were older white females who were of lower socioeconomic status that completed high school or some college. Diabetes mellitus and congestive heart failure were the most prevalent comorbid conditions. Only 18 participants were classified as having no depression. The majority of participants were in the maintenance or contemplation stage. Participants who smoked had high nicotine dependence and wanted to quit smoking. Overall, participants saw more cons to smoking and were engaged in the processes of change. Conclusions: There is a need to assess COPD patients for depression and to assess COPD patients’ smoking behaviors and readiness to change. Depression does affect patients’ smoking behaviors and readiness to change. Adequate treatment of depression could promote an individual to move through the stages of change from chronic contemplation to action,