Certified Smoking Cessation Units in Spain: High Potential for Detection of Undiagnosed Chronic Obstructive Pulmonary Disease and Profile of Newly Diagnosed Cases.

Purpose: Smokers attending smoking cessation units (SCUs) may offer a unique opportunity for early recognition of undiagnosed chronic obstructive pulmonary disease (COPD). We aimed at assessing the impact of SCUs on the early diagnosis of COPD and describing the clinical and smoking profile of newly-diagnosed COPD cases at SCUs certified by the Spanish Society of Respiratory Diseases and Thoracic Surgery (SEPAR).
Patients and Methods: A multicenter cross-sectional observational cohort study (DIPREPOQ study) was performed in eight SEPAR-certified SCUs in Spain. Adult current smokers with no previously diagnosed respiratory disease and having one o more respiratory symptoms were included. Lung functional tests were performed and previously undiagnosed COPD cases were identified and characterized based on national guidelines.
Results: Out of 401 individuals newly attending the SCUs, 252 participants were included and 73 (28.9%) met the definition of previously undiagnosed COPD. A characterization of patients with COPD being newly recognized in SCUs showed: age (mean±SD) 61±9 years; men 59%; active work status 53.1%; functional class I/II dyspnea 82.8%, GOLD state mild/moderate/severe 57%/31%/12%; non-exacerbators 90%, CAT 14±4; emphysema in X-rays 40%. Most common co-morbidities were cardiovascular and psychiatric (anxiety and depression) ones. Usual smoking history included a lengthy smoking history (41±9 years) and a current consumption of 24±9 cigarettes/day.
Conclusions and Implications: Consistently certified SCUs can have a substantial contribution to early diagnosis of COPD. A typical profile of newly detected cases is reported, with most patients being men at their early sixties, with mild symptoms and with high and lengthy smoking history. Our study reports a high usefulness of lung functional tests to detect undiagnosed COPD in appropriately selected participants attending SCUs at a large national scale, using a standardized methodology. This is likely to be facilitated by the certification of SCUs using well-defined requirements by national scientific societies.
Competing Interests: JARM has received honoraria for lecturing, scientific advice, participation in clinical studies or writing for publications for (alphabetical order): AstraZeneca, Boehringer Ingelheim, Chiesi, Laboratorios Esteve, Faes, Gebro, GSK, Menarini, Pfizer, and Rovi, outside the submitted work. CRC has received honoraria for lecturing, scientific advice, participation in clinical studies or writing for publications for pharmaceutical companies, such as Laboratorios Esteve, GSK, Menarini Mundi-Pharma, Novartis, Pfizer, and Teva Pharmaceutical. JIGO has received honoraria for lecturing, scientific advice, participation in clinical studies or writing for publications for (alphabetical order): AstraZeneca, Chiesi, Esteve, Faes, Gebro, Menarini, Pfizer, and Rovi. EPE has received lecture fees and/or support for conference attendance from several pharmaceutical companies, such as Chiesi, Boehringer Ingelheim, Menarini, Pfizer, Novartis, Laboratorios Esteve, Teva Pharmaceutical, Ferrer, or Rovi. FJCG has received lecture fees, consultancy fees and/or support for conference attendance from several pharmaceutical companies, such as GlaxoSmithKline, Chiesi, Boehringer Ingelheim, Mundipharma, Menarini, Pfizer, Novartis, Laboratorios Esteve, Teva Pharmaceutical, Ferrer, Rovi, Roche, Astra Zeneca, Bial, Actelion, Grifols, CSL Behring, Faes Farma, and Gebro Pharma. CAJ-R has received honoraria for lecturing, scientific advice, participation in clinical studies or writing for publications for (alphabetical order): Gebro, Menarini and Pfizer. AAA is full-time employee at Laboratorios Esteve, Spain. The remaining authors report no conflicts of interest to be disclosed in this work.
(© 2021 Riesco-Miranda et al.)