Evaluation of smoking behaviour according to gender, symptoms and diagnoses at a pulmonology outpatient visit

Abstract

Smoking during the hours prior to an examination in a pulmonology outpatient clinic may provide valuable information regarding patients’ smoking behaviour. The objective of our study was to examine the association of gender, symptoms, and current diagnoses with active smoking status and smoking on the day of outpatient visits. This was a retrospective, observational, cross-sectional study. A total of 1863 patients were included. Symptoms, diagnoses, smoking history, and the last smoking time prior to the outpatient clinic visit were recorded. Males were more likely to be active or ex-smokers, while females were more likely to be non-smokers (p<0.001, for all). The rate of continued smoking was higher in younger patients (p<0.001), patients with chest/back pain (p=0.003), and in women (p<0.001), whereas smoking cessation was more common in COPD (p<0.001) and bronchiectasis patients (p=0.002), sputum producing patients (p=0.02), and men (p<0.001). A total of 66.9 % (n=420) of the active smoking group smoked on the day of the outpatient clinic visit. The median value of the smoking duration before the examination was 60 minutes (64.5%, n=271) on the day of the outpatient clinic visit. Smoking behaviour was significantly more common within the last 24 hours (p<0.001) and on the day of the clinic visit among female smokers (p<0.001). Patients with COPD, bronchiectasis, or sputum production were significantly less likely to smoke on the day of outpatient visit (p<0.001, p=0.05, and p=0.004, respectively), while younger patients, asthmatic patients, and those with chest/back pain were significantly more likely to smoke on outpatient visit day (p<0.001, p=0.02, p<0.001, respectively). Thus, female gender and pain emerged as the most important determinants of smoking behaviour on the outpatient visit day. The success of anti-smoking campaigns may be positively impacted by paying more attention to gender differences, specific patient groups, and appropriate management of existing symptoms.