Does additional support by nurses enhance the effect of a brief smoking cessation intervention in people with moderate to severe chronic obstructive pulmonary disease? A randomised controlled trial

BackgroundSmoking cessation is the primary disease modifying intervention for chronic obstructive pulmonary disease (COPD).SettingA Regional Respiratory Centre (RRC) out-patient department in Northern Ireland.MethodsA randomised controlled trial (RCT) evaluated the effectiveness of brief advice alone or accompanied by individual nurse support or group support facilitated by nurses. Smoking status was biochemically validated and stage of change, nicotine addiction and dyspnoea were recorded at 2, 3, 6, 9 and 12 months.ParticipantsNinety-one cigarette smokers with COPD were enrolled in the study (mean age 61years, 47 female).ResultsAfter 12 months cessation rates were not significantly different between groups (p=0.7), but all groups had a significant reduction in their nicotine addiction (p=0.03–0.006). No changes in subjects’ motivation or dyspnoea were detected over the 12 months.ConclusionPatients with COPD were unable to stop smoking regardless of the type of support they received. Harm reduction may be a more appropriate goal than complete cessation for intractable smokers and nurses must evaluate their role in this arena.