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Eur Respir J 2007; 29:390-417
Copyright ©ERS Journals Ltd 2007

Smoking cessation in patients with respiratory diseases: a high priority, integral component of therapy

P. Tønnesen1, L. Carrozzi2, K. O. Fagerström3, C. Gratziou4, C. Jimenez-Ruiz5, S. Nardini6, G. Viegi7, C. Lazzaro8, I. A. Campell9, E. Dagli10 and R. West11

1 Dept of Pulmonary Medicine, Gentofte Hospital, Copenhagen, Denmark, 2 Cardiopulmonary Dept, University Hospital of Pisa, and 7 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, and 6 Smoking Cessation Clinic, Vittorio Veneto, and 8 Economic Evaluation of Health Care Programmes, Pharmaco-economics and Health Economics Researching and Consulting, Milan, Italy, 3 Smoker's Information Centre, Helsingborg, Sweden, 4 Smoking Cessation Clinic, Evgenidio Hospital, Medical School, Athens University, Athens, Greece, 5 Smokers Clinic, Institute of Public Health, Madrid, Spain, 9 Llandough Hospital, Penarth, and 11 Cancer Research UK Health Behaviour Unit, Dept of Epidemiology and Public Health, University College London, London, UK, 10 Medical Faculty, Marmara University, Istanbul, Turkey.

CORRESPONDENCE: P. Tønnesen, Dept of Pulmonary Medicine Y, Gentofte University Hospital, 2900 Hellerup, Copenhagen, Denmark. Fax: 45 39777693. E-mail: philipt{at}dadlnet.dk

Keywords: Chronic obstructive pulmonary disease, guidelines, respiratory patients, smoking cessation

Received: May 7, 2006
Accepted August 28, 2006


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Smoking cessation is the one of the most important ways to improve the prognosis of patients with respiratory disease. The Task Force on guidelines for smoking cessation in patients with respiratory diseases was convened to provide evidence-based recommendations on smoking cessation interventions in respiratory patients.

Based on the currently available evidence and the consensus of an expert panel, the following key recommendations were made. 1) Patients with respiratory disease have a greater and more urgent need to stop smoking than the average smoker, so respiratory physicians must take a proactive and continuing role with all smokers in motivating them to stop and in providing treatment to aid smoking cessation. 2) Smoking cessation treatment should be integrated into the management of the patient's respiratory condition. 3) Therapies should include pharmacological treatment (i.e. nicotine replacement therapy, bupropion or varenicline) combined with behavioural support. 4) Respiratory physicians should receive training to ensure that they have the knowledge, attitudes and skills necessary to deliver these interventions or to refer to an appropriate specialist. 5) Although the cost of implementing these recommendations will partly be offset by a reduction in attendance for exacerbations, etc., a budget should be established to enable implementation.

Research is needed to establish optimum treatment strategies specifically for respiratory patients.




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