Effectiveness of immediate appointment scheduling in smoking cessation clinics for patients with chronic airway diseases: Preliminary results from a randomized trial.

INTRODUCTION: Patients with airway diseases who bear the burden of smoking need access to smoking cessation support. We aimed to investigate the impact of immediately scheduled appointments on access to smoking cessation clinics compared with usual care in this patient group. METHODS: This multicenter, prospective, randomized, open-label study was conducted between November 2022 and June 2023 at pulmonary outpatient clinics. The study included adult patients who were current smokers and had a diagnosis of asthma, COPD, or bronchiectasis for at least six months. Sequentially randomization was used for the allocation of patients in a 1:1 ratio to two study arms: the usual support arm (representing the current standard care procedure) and the immediate support arm (involving intensive brief cessation advice followed by the immediate arrangement of an appointment at the same clinic's smoking cessation service). After one week, both patient groups were contacted by phone to assess their quit attempts and whether they had sought assistance from smoking cessation outpatient clinics (SCCs). RESULTS: A total of 397 patients were enrolled in the study, with 199 allocated to the usual support arm and 198 allocated to the immediate support arm. Within the first week, 18.1% of patients in the usual support arm and 77.3% of patients in the immediate support arm sought assistance from the smoking cessation clinic (p<0.001). The rate of smokers without an intention to quit was 56.7% in the usual support arm and 27.7% in the immediate support arm in the first week of follow-up. Immediate appointment scheduling was significantly associated with a 13-fold (OR=13.38; 95% CI: 8.00-22.38) increase in referral rates in the multivariate logistic regression model. CONCLUSIONS: Arranging instant appointments has increased access to SCCs by 13 times compared to the usual care, this group of patients should be given an immediate appointment to SCCs.

Post-COVID Interstitial Lung Disease: How do We Deal with This New Entity?

Background: In the postacute phase of coronavirus disease-2019 (COVID-19), survivors may have persistent symptoms, lung function abnormalities, and sequelae lesions on thoracic computed tomography (CT). This new entity has been defined as post-COVID interstitial lung disease (ILD) or residual disease. Aims: To evaluate the characteristics, risk factors and clinical significance of post-COVID ILD. Study Design: Multicenter cross-sectional analysis of data from a randomized clinical study. Methods: In this study, patients with persistent respiratory symptoms 3 months after recovery from COVID-19 were evaluated by two pulmonologists and a radiologist. post-COVID ILD was defined as the presence of respiratory symptoms, hypoxemia, restrictive defect on lung function tests, and interstitial changes on follow-up high-resolution computed tomography (HRCT). Results: At the three-month follow-up, 375 patients with post-COVID-19 syndrome were evaluated, and 262 patients were found to have post-COVID ILD. The most prevalent complaints were dyspnea (n = 238, 90.8%), exercise intolerance (n = 166, 63.4%), fatigue (n = 142, 54.2%), and cough (n = 136, 52%). The mean Medical Research Council dyspnea score was 2.1 ± 0.9, oxygen saturation was 92.2 ± 5.9%, and 6-minute walking distance was 360 ± 140 meters. The mean diffusing capacity of the lung for carbon monoxide was 58 ± 21, and the forced vital capacity was 70% ± 19%. Ground glass opacities and fibrotic bands were the most common findings on thoracic HRCT. Fibrosis-like lesions such as interlobular septal thickening and traction bronchiectasis were observed in 38.3% and 27.9% of the patients, respectively. No honeycomb cysts were observed. Active smoking [odds ratio (OR), 1.96; 95% confidence interval (CI), 1.44-2.67), intensive care unit admission during the acute phase (OR, 1.46; 95% CI, 1.1-1.95), need for high-flow nasal oxygen (OR, 1.55; 95% CI, 1.42-1.9) or non-invasive ventilation (OR, 1.31; 95% CI, 0.8-2.07), and elevated serum lactate dehydrogenase levels (OR, 1.23; 95% CI 1.18-1.28) were associated with the development of post-COVID ILD. At the 6-month follow-up, the respiratory symptoms and pulmonary functions had improved spontaneously without any specific treatment in 35 patients (13.4%). The radiological interstitial lesions had spontaneously regressed in 54 patients (20.6%). Conclusion: The co-existence of respiratory symptoms, radiological parenchymal lesions, and pulmonary functional abnormalities which suggest a restrictive ventilatory defect should be defined as post-COVID-19 ILD. However, the term "fibrosis" should be used carefully. Active smoking, severe COVID-19, and elevated lactate dehydrogenase level are the main risk factors of this condition. These post-COVID functional and radiological changes could disappear over time in 20% of the patients.

Mid-term outcomes of a smoking cessation program in hospitalized patients in Türkiye.

INTRODUCTION: 'Teachable moments', such as inpatient treatment periods, can be turned into opportunities for smokers to acquire healthy living behaviors. This study was conducted to evaluate the outcomes of smoking cessation interventions in an inpatient hospital setting. METHODS: Data were collected for this single-arm prospective intervention cohort study between October 2021 and March 2022 from hospitalized patients at Recep Tayyip Erdogan University Training and Research Hospital in Türkiye. Smoker patients received smoking cessation counseling and brief smoking cessation interventions during their hospitalization and were informed about how to apply to our hospital's smoking cessation outpatient clinic after discharge. They were followed via phone on the 3rd, 5th, and 7th day and the 1st, 3rd, 6th, and 12th month after their discharge, regarding their quit status as well as admissions to smoking cessation clinics. Quitters were confirmed by exhaled air carbon monoxide testing. Logistic regression analysis was performed to evaluate the presence of admission to the emergency department and family physicians at follow-up at 1st year. The model was adjusted in terms of age, sex, presence of malignancy, and education level. RESULTS: Of the 183 patients included in the study, 163 participants completed periodic follow-up during one year, with quit rate of 47.2%. The rate of anxiety was higher among non-quitters compared to quitters (9.4% vs 1.2%) (p=0.024). Non-quitters were 19 times more likely to have emergency department admissions (AOR=19.64; 95% CI: 8.08-47.68) and eight times more likely to have family doctor visits (AOR=8.43; 95% CI: 4.05-17.53) than quitters. CONCLUSIONS: This cessation program evaluated the quit rates of hospitalized patients in the first year and revealed that the rate of anxiety was higher in non-quitters compared to quitters. It would be an important approach to include psychiatric support in this practice.

Neglecting the neglected: Tobacco cessation support is essential for the management of asthma and COPD.

INTRODUCTION: Asthma and COPD management have a broad framework, and smoking cessation plays an essential role. We examine the management of asthma and COPD patients not only for inhaler treatment options but also for essential interventions, such as smoking cessation support. METHODS: Data were collected cross-sectionally from pulmonology departments of three government hospitals in Türkiye between May and September 2022. Patients aged ≥18 years who had been diagnosed with asthma or COPD for at least a year, were included in the study. The demographic and clinical characteristics of the patients were investigated. Routine cessation interventions were implemented for current smokers, and they were followed via phone calls after one month regarding their quit status and access to cessation clinics. RESULTS: Data from 145 patients with asthma and 148 patients with COPD were analyzed. The rate of current smoking among patients with asthma and COPD was 18.8% and 34.5%, respectively. Current smoking was negatively associated with age (<65 years) and disease duration (years) for both diseases (p<0.05). In addition, for asthmatics, presence of pulmonary disease in the family (OR:0.28, 95% CI: 0.10-0.79) and for COPD patients presence of hospitalization (OR: 0.26, 95% CI: 0.07-0.93) were negatively associated with current smoking. After one month, 85.1% of current asthmatic smokers had not tried to call a quitline, while 14.8% had tried to contact a quitline. Among current smoker COPD patients, only 1.9% had visited a smoking cessation clinic. CONCLUSIONS: Tobacco cessation support seems to be neglected in asthma and COPD management. Instead, pulmonologists and patients focus on pharmaceutical treatments, which constitute the other component of care.

An Alpha-1 Antitrypsin Deficiency Screening Study in Patients with Chronic Obstructive Pulmonary Disease, Bronchiectasis, or Asthma in Turkey.

Purpose: Alpha-1 antitrypsin deficiency (AATD) is a rare hereditary condition characterized by decreased serum alpha-1 antitrypsin (AAT) levels. We aim to identify AATD in patients with chronic obstructive pulmonary disease (COPD), bronchiectasis, or asthma and to report the frequency of AAT variants in Turkey. Patients and Methods: This non-interventional, multicenter, prospective study was conducted between October 2021 and June 2022. Adult patients with COPD, bronchiectasis, asthma, liver symptoms, or family members with AATD were included. Demographic and clinical characteristics, pulmonary diagnosis, respiratory symptoms, and AAT serum levels were assessed. Whole blood samples were collected as dried blood spots, and the most common AATD mutations were simultaneously tested by allele-specific genotyping. Results: A total of 1088 patients, mainly diagnosed with COPD (92.7%) and shortness of breath (78.7%), were assessed. Fifty-one (5%) were found to have AATD mutations. Fifteen (29.4%) patients had Pi*S or Pi*Z mutations, whereas 36 (70.6%) patients carried rare alleles Pi*M malton (n=18, 35.3% of mutations), Pi*I (n=8, 16%), Pi*P lowell (n=7, 14%), Pi*M heerlen (n=2, 4%), and Pi*S iiyama (n=1, 2%). The most common heterozygous combinations were Pi*M/Z (n=12, 24%), and Pi*M/M malton (n=11, 22%). Ten patients with severe AATD due to two deficiency alleles were identified, two with the Pi*Z/Z genotype, four with the genotype Pi*M malton/M malton, three with Pi*Z/M malton, and one with Pi*Z/M heerlen. Conclusion: Our results identified AATD mutations as a genetic-based contributor to lung disease in patients with COPD or bronchiectasis and assessed their frequency in a population of Turkish patients.

Mediastinitis and subcutaneous abscess complicated after EBUS-TBNA of 2R mediastinal lymph node.

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUSTBNA) is a minimally invasive diagnostic tool used for the evaluation of mediastinal lymphadenopathy. It is a safe procedure, but complications such as bleeding and infection may occur. We report a case of a patient who developed a subcutaneous abscess abscess and mediastinitis after EBUSTBNA. A 75-year-old male with a history of right nephrectomy due to renal cell carcinoma and lung adenocarcinoma history underwent EBUS-TBNA for the evaluation of a right upper paratracheal lymph node. Two weeks after the procedure, the patient presented to the emergency department with skin induration and erythema on the right clavicular area. A non-contrast neck and thorax CT scan was performed, which revealed an extensive subcutaneous abscess on the right clavicular area, extending to the supraclavicular region. The patient was hospitalized, and empirical intravenous antibiotics were initiated due to deep neck infection. Repeated drainage of the subcutaneous abscess was performed. Bacteriologic examination revealed Streptococcus mitis. The patient showed improvement with antibiotic treatment, and a follow-up ultrasound showed a decrease in the size of the abscess and was discharged approximately four weeks after hospitalization. Although very rare, serious infectious complications may develop after EBUSTBNA, and our case report is an important example regarding its management process.

Turkish Thoracic Society's Statement Report on Electronic Cigarettes and Heated Tobacco Products.

Tobacco addiction, which causes the death of more than 8.5 million people in the world every year, is a preventable global public health problem. There are 1.1 billion adult smokers worldwide and 60% of them desire or intend to quit but unfortunately, the tobacco industry continues to profit at the expense of people's lives by marketing electronic cigarettes and heated tobacco products as a smoking cessation method and they continue to poison young people with new threat tobacco products, promising a "smoke-free future" Turkish Thoracic Society is actively involved in the implementation of the National Tobacco Control Program to protect public health and has warned and raised awareness of new threats to the youth, such as electronic cigarettes and heated tobacco products. The purpose of this report is to provide information about electronic cigarettes and heated tobacco products and to present TTJ's position on the subject.

Role of tobacco exposure in the course of COVID-19 disease and the impact of the disease on smoking behavior.

BACKGROUND: The effect of COVID-19 on smoking behavior is not fully known. Studies evaluating the link between smoking and COVID-19 have controversial results. This study aims to evaluate patients' smoking status with COVID-19 and the effect of COVID-19 on smoking behavior. METHODS: Data were collected from 150 COVID-19 patients with a positive polymerase chain reaction test for SARS-CoV-2 between 11 March 2020 and 15 May 2020 in Rize, Turkey. Patients were interviewed by phone calls 2 months after their recovery. After 9 months, a follow-up was performed for those who quit smoking. RESULTS: Of the participants, 19 (12.7%) were current smokers before the COVID-19 diagnosis, and 15 (78.9%) of them stated that they quit smoking after their diagnosis. After nine months of follow-up, 11 of those 15 participants (57.8%) sustained abstinence. CONCLUSION: Smoking cessation rates are high in people with COVID-19. Besides, the frequency of sustaining abstinence in the long term was also high in these individuals. The COVID-19 pandemic should be viewed as an open opportunity to strengthen and prioritize smoking cessation activities.

Rate of History of Tuberculosis Among Healthcare Workers in Turkey: A Cross-Sectional Study.

OBJECTIVES: Healthcare workers (HCWs) possess a high risk for both latent tuberculosis infection (LTBI) and active disease. This study aimed to investigate tuberculosis (TB) disease history in hospital staff working in healthcare institutions in the Eastern Black Sea Region of Turkey. MATERIAL AND METHODS: This study included 460 HCWs employed in 5 hospitals in the Eastern Black Sea Region of Turkey. Between May 01 and July 31, 2016, the participants were asked to answer a questionnaire, including data about TB history. The data about family TB history, Bacilli Calmette-Guerin (BCG) vaccination, or tuberculin skin test (TST) application before starting work were also evaluated. RESULTS: Of the 460 participants, 69.3% were women (n=319) and 30.7% (n=141) were men. The mean age was 32 (17-63) years. A total of 8 participants (1.7 %) had TB history. There was no statistically significant relationship between TB history and age, sex, body mass index (BMI), smoking habits, or presence of comorbidities (p>0.05 for all variables); family history of TB (p<0.001) and TST positivity (p<0.001) were significantly higher in participants with a TB history. Each participant was checked for the presence of both BCG scar and TST positivity. No difference was noted between positive TB history and negative HCWs (p>0.05). The duration of work (years) was higher in participants with a TB history. The p value was very close but did not reach the limits of significance (p=0.059). CONCLUSION: In this study, the rate of TB among HCWs was 1.7% (8 of 460 HCWs). Family history of TB and TST positivity are strong predictors of TB in HCWs.

ERS International Congress 2020: highlights from the Epidemiology and Environment Assembly.

In this article, early career members of the Epidemiology and Environment Assembly of the European Respiratory Society (ERS) summarise a selection of five sessions from the ERS 2020 Virtual International Congress. The topics covered include risk factors for chronic respiratory diseases over the life course, from early life origins to occupational exposures in adulthood, and the interplay between these risk factors, including gene-environment interactions. Novel results were also presented on smoking prevention and potential risks of vaping. Finally, the challenges and opportunities for epidemiological and environmental research brought by the coronavirus disease 2019 (COVID-19) pandemic were a major topic of this year's congress.

Weight Loss as the First-Line Therapy in Patients with Severe Obesity and Obstructive Sleep Apnea Syndrome: the Role of Laparoscopic Sleeve Gastrectomy.

PURPOSE: The objective of this study is to investigate the effects of laparoscopic sleeve gastrectomy (LSG) on the polysomnographic parameters related to OSAS. MATERIALS AND METHODS: We conducted this 3-year prospective cohort study in a tertiary care center between December 2016 and December 2019. In total, we enrolled 31 patients with severe obesity who underwent full-night polysomnography (PSG) before LSG. Later, the patients were re-evaluated by full-night PSG 12 months after the surgery. RESULTS: The mean age of the patients was 44.1 ± 9.6 years. The mean body mass index (BMI) decreased significantly from a mean value of 49.8 ± 8.5 kg/m2 at baseline to 33.2 ± 8.2 kg/m2 and a percent BMI (%BMI) reduction of 33.8 ± 10.4% and a percent total weight loss (%TWL) of 35.4 ± 10.8% was achieved on the same day of the postsurgical PSG (p < 0.001). There was a remarkable improvement in the AHI (baseline: 36.1 ± 27.1, 12 months after the surgery: 10.3 ± 11.8; difference: 25.8 ± 22.8 events per hour) (p < 0.001). Importantly, there was a decrease in the percentage of non-rapid eye movement (NREM) 2 (p < 0.001), whereas NREM 3 and REM stages witnessed a significant increase (p = 0.001 and p < 0.001, respectively) after the surgery. CONCLUSION: The results of this study showed that weight loss after LSG yields improvement not only in AHI but also in many polysomnographic parameters such as sleep quality and desaturation indices.

Survival analysis and factors affecting survival in patients who presented to the medical oncology unit with non-small cell lung cancer

Background/aim: This study aimed to investigate the effect of clinical and pathological indicators at the time of the diagnosis on overall survival in patients recently diagnosed with non-small cell lung cancer. Materials and methods: The study population consisted of patients who were diagnosed at the Faculty of Medicine at Isparta Süleyman Demirel University Hospital between January 1, 2010 and December 31, 2017 and presented to the medical oncology outpatient clinic. Results: A total of 518 patients were evaluated, including 260 patients with squamous cell carcinoma, 207 patients with adenocarcinoma, 50 patients with non-small cell lung cancer-not otherwise specified, and 1 patient with large cell carcinoma. The average life expectancy was found to be 11.50 ± 1.40 months in patients with squamous cell carcinoma, 12.60 ± 1.59 months in patients with adenocarcinoma, and 8.70 ± 1.87 months in the other patients. The estimated 5-year relative survival rate for non-small cell lung cancer was 8% (7% for men and 18% for women). In the multivariate analysis, sex being male (HR, 2.41; P < 0.001), a performance status >2 (HR, 1.70; P < 0.001), the stage of cancer (HR, 1.37; P = 0.045), the presence of bone or liver metastasis (HR, 1.44, P = 0.009, HR, 1.57; P = 0.016, respectively), and the patient not having received radiotherapy (HR, 3.25; P < 0.001) or chemotherapy (HR, 1.85; P = 0.001) were defined as statistically significant predictive factors that reduced the overall survival. Conclusions: In this study, sex, stage, performance status, the presence of liver or bone metastases, and treatment had an effect on overall survival.

The effects of mold sensitivity on the clinical characteristics of adult asthmatic patients.

INTRODUCTION: The effects of mold sensitivity on the development and course of asthma have been researched previously, although study results vary. We sought to evaluate the characteristics of our mold-sensitive patients in comparison with those of other adult asthmatic patients. MATERIALS AND METHODS: Data were collected retrospectively from adult asthmatic patients who underwent regular follow-ups at our tertiary care outpatient clinic for immunology and allergic diseases. Patients were grouped and compared according to three categories of aeroallergen sensitivity status determined via a skin prick test. The study variables were demographic data, asth-ma-onset age, comorbid conditions, asthma-related emergency department visits and hospitalizations, systemic corticosteroid burst, asthma control assessment tests, and pulmonary function tests. RESULTS: In total, 242 patients' data were evaluated. Their mean age was 48.6 ± 15.4 years, with female predominance (81.4%). Mold-sensitive asthmatics composed 34.7%, while the aeroallergen-sensitive group without molds (33.1%) and the non-sensitized group (32.2%) composed the rest. The mold-sensitive group had a higher rate of polysensitization (92.8%) than the sensitized group without molds. In multinomial logistic regression analysis, mold sensitivity was positively associated with shorter asthma duration, absence of sinonasal polyposis, presence of allergic rhinitis, and generally well-controlled asthma compared to the non-sensitized group. Also, mold sensitivity was positively associated with shorter asthma duration, drug allergy, and absence of systemic corticosteroid bursts compared to the sensitized group without molds in logistic regression analysis. CONCLUSION: Our mold-sensitive asthmatic patients demonstrated better asthma symptom control. It should be considered that mold sensitization in adult asthmatics is not always a poor prognostic factor.

Corrigendum: How does reimbursement status affect smoking cessation interventions? A real-life experience from the Eastern Black Sea region of Turkey.

[This corrects the article DOI: 10.18332/tid/100412.].

How does reimbursement status affect smoking cessation interventions? A real-life experience from the Eastern Black Sea region of Turkey.

INTRODUCTION: In the last decade, outpatient smoking cessation clinics (SCCs) in Turkey have been extended countrywide. Initially, only counseling was covered under health insurance. In 2011 and 2015, free varenicline and bupropion preparations were distributed to SCCs, periodically. In the current study we aimed to compare outcomes between the free and paid medication periods. METHODS: Patients applied to the local SCC in a secondary health care unit between June 2014 and June 2017. They were evaluated for SC interventions and had phone visits after their third month; these records were included in the study. Patients were grouped and evaluated according to medication's reimbursement status: free medication period (FP) and paid medication period (PMP). RESULTS: In total, 733 patients applied to the SCC, 77.7% of them had applied during the FP. Analyses were made involving 417 patients who had records of third-month phone visit. Mean age of the patients was 44.0±13.7 years with the majority of patients (65%) being male. Sociodemographic characteristics of patients in both groups were not statistically different, while the percentage of patients with comorbid diseases was lower in the FP group (p<0.05). Treatment choices were different- the bupropion-prescribed group's rate was similar in both periods (53.5% in PMP vs 52.0% in FP), however varenicline was mostly prescribed in the FP (35.8% vs 14.1%) while nicotine replacement therapy was mostly prescribed in the PMP (32.4% vs 12.1%) (p<0.05). Patients who used the advised treatment for at least 30 days (treatment adherent) and the rate of quitters at the third month were higher in FP (p<0.05) from univariate analysis, however these differences were not statistically significant when a multivariate analysis was performed. CONCLUSIONS: Our study showed that the free medication period increased the quit attempts but the increased in treatment adherence and quit success of the participating smokers was not obvious.

Prevalence and determinants of smoking status among university students: Artvin Çoruh University sample.

BACKGROUND AND AIM: Smoking is still a public health concern in many countries, especially among young adults. Consequently, we determined what factors affect university students' smoking behavior in Turkey. METHODS: This cross-sectional study was conducted between March and June 2017 using a simple random sampling method. A self-administered questionnaire was used to collect information on participants' (N = 2,505; mean age = 20.9 ± 2.5 years; 58.9% women) sociodemographic characteristics, cigarette smoking status, and related risk factors. Univariate analysis and multivariate logistic regression analysis were performed with the Backward likelihood-ratio method. RESULTS: Students were completing either two- or four-year degrees (45.6% and 54.4%, respectively). Regarding familial smoking behavior, 36.1% had a father who smoked, 10.3% had a mother who smoked, and 15.0% had siblings who smoked. Among participants, 27.9% were current smokers: 46% of the men and 15.3% of the women. Mean smoking onset age was 16.34 ± 2.72 years (15.65 ± 2.67 years for men and 16.34 ± 2.72 for women (p < .05). Mean Fagerströmtest score was 4.43 ± 1.82, and women had lower test scores than did men (p < .05). After controlling for potential confounders in multivariate analyses, five factors were significantly positively associated with current smoking: being a man (odds ratio (OR): 3.43; 95% confidence interval (CI): 2.75-4.28), studying in a two-year program (OR: 1.74; 95% CI: 1.39-2.18), having at least one immediate family member who smoked (OR: 1.63; 95% CI: 1.31-2.04), having all close friends who smoked (OR: 1.81; 95% CI: 1.40-2.33), and alcohol consumption (OR: 4.39; 95% CI: 3.51-5.49). CONCLUSION: There was a higher smoking rate among our study population, both compared to similar national studies and Turkey's overall smoking rate. Underlying factors should be evaluated via qualitative studies and preventive strategies should be implemented accordingly.

Factors associated with current smoking in COPD patients:A cross-sectional study from the Eastern Black Sea region of Turkey.

INTRODUCTION: Even though smoking is a major reason for the development and progression of chronic obstructive pulmonary disease (COPD)-and quitting smoking is the only way to stop its progression-a significant number of smokers still continue to smoke after being diagnosed with COPD. The aim of this study is to compare the clinical and demographic characteristics of COPD patients who are current and former smokers and to find factors associated with their current smoking status. METHODS: For this study, data were collected between June 2015 and August 2016; COPD patients who had been regularly visiting Hopa State Hospital's outpatient clinic over the last year or longer were included. Their demographic, clinical and functional data were recorded. Patients completed a pulmonary function test, six-minute walk test (6-MWT), COPD assessment test (CAT), and modified Medical Research Council (mMRC) dyspnea scale. Comparisons were then made according to their smoking status. RESULTS: In total 100 patients were included in the study; with a mean age of 63.4±10.7 years and mostly males (94%). Regarding smoking status, 49% were current smokers and 51% were former smokers. Multivariate logistic regression analysis revealed that current smoking was negatively associated with age (odds ratio, OR=0.93, 95% confidence interval, CI=0.88-0.96) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage (OR=0.32, 95% CI=0.13- 0.79), and was positively associated with six-minute walk distance (OR =1.005, 95% CI=1.001-1.009) and CAT score (OR=1.07, 95% CI=1.009-1.13). CONCLUSIONS: Nearly half of the COPD patients in the study continued smoking even after having been diagnosed with COPD. The younger patients, with better lung function, better exercise capacity and poor quality of life were associated with current smoking.

Treatment adherence and short-term outcomes of smoking cessation outpatient clinic patients.

INTRODUCTION: Previous studies have shown that adherence to treatment is fundamental to success in smoking cessation. However, smoking cessation medication regimens are limited significantly by the struggle to adhere to them. This study was conducted to evaluate the factors associated with treatment adherence and quitting success in a group of patients that applied to our smoking cessation outpatient clinic (SCC). METHODS: Patients that applied to SCC between April 2015 and December 2016 who were evaluated, found suitable for smoking cessation interventions and started pharmacological treatment were included in this study. Only those who could be reached by phone three months after their first application became participants. Those who had used the prescribed treatment for at least 30 days were grouped as treatment-adherent. RESULTS: In total, data for 346 patients were evaluated. Mean (±SD) age was 44.3±13.9 years; most of them were male (63%), primary school graduated (36.1%), self-employed (43.7%), and had no comorbid diseases (71%). Bupropion was started in 52% of the patients, that rate was 35.8% for varenicline and 12.1% for a combination of the nicotine patch and gum. Mean days for treatment use was 20.9±18.5; 59% of the patients were non-adherent to their treatment and 51.7% had only one control visit number. Adverse reactions due to treatment were recorded in 25% of participants, and at their third month 37.9% of them had quit smoking. In multivariate logistic regression analysis, increase in control visit number, absence of adverse reaction, and varenicline use, were each associated with higher treatment adherence (p<0.001) and only being in the treatment-adherent group was associated with quit success (OR=3.01, 95% CI: 1.88-4.81, p=0.001). CONCLUSIONS: This study showed that most patients did not use their prescribed SC treatments adequately; a main factor that affects quit success is treatment adherence. There is a need for closer monitoring and follow-up to ensure adequate use of treatment of patients.