Health related quality of life in adults with COPD: Who is still smoking and where can public health and clinical medicine intervene?

Health-related quality of life (HRQOL) in adults with chronic obstructive pulmonary disease (COPD) is a major component of care. HRQOL can be impacted by exacerbations. Exacerbations can be reduced through smoking cessation. Identifying smokers with COPD and describing HRQOL and utilization will assist practitioners with avenues for intervention. This research described HRQOL in smokers/non-smoker and identified factors associated with smoking and avenues for intervention in adults with COPD diagnosed by a breathing test.

This was a cross-sectional study using 2011 Behavioral Risk Factor Surveillance System data. Weighted multivariable logistic regression examined: 1) HRQOL in current vs. former smokers and 2) factors associated with smoking and opportunities for intervention in adults with COPD and diagnostic breathing test.

Forty-nine percent of adults were former smokers. Current smokers were more likely to report fair/poor general health (odds ratio (OR): 1.30; confidence interval (CI): 1.05-1.61), and ≥14 days of poor mental (OR: 1.80; CI: 1.42-2.29) or physical health (OR: 1.29; CI: 1.05-1.58) and social functioning (OR: 1.52; CI: 1.21-1.90). Those who were divorced/separated/widowed (OR=1.4; CI: 1.1-1.7) or never married (OR=1.5, CI: 1.0-2.2) or reported depression (OR=1.4; CI: 1.1-1.7) were more likely to be current smokers. Those with a personal doctor (OR=0.48; CI: 0.32-0.71) and who had seen a doctor about shortness of breath (OR=0.77; CI: 0.63-0.94) were less likely to be current smokers.

Current smokers have worse HRQOL and are less likely to have healthcare utilization when compared to former smokers indicating a need for public health interventions outside the clinical system.