Burden of smoking on quality of life in patients with chronic obstructive pulmonary disease

Abstract

The objective of this study was to assess the impact of smoking on health-related quality of life, Work Productivity and Activity Impairment (WPAI) in chronic obstructive pulmonary disease (COPD) patients. Respondents of the 2009/2010 US National Health and Wellness Survey (NHWS), aged ≥40 years, with COPD, chronic bronchitis or emphysema, were included in the study. Current and former (had not smoked for ≥11 years) smokers were compared. Physical component summary (PCS) and mental component summary (MCS) scores from the Short Form-12 version 2 (SF-12v2), health utilities (SF-6D) and WPAI were evaluated. Differences between current (n = 1685) and former (n = 1932) smokers were revealed: MCS (44.80, 46.73; p < 0.01); PCS (35.12, 35.79; p < 0.1); SF-6D (0.63, 0.65; p < 0.05). WPAI: presenteeism (23%, 18%; p < 0.05); work impairment (25%, 21%; p < 0.05); activity impairment (52%, 49%; p < 0.01). In conclusion, COPD patients who smoke have poorer health-related quality of life, impaired productivity and higher healthcare costs than former smokers.

Keywords::

• activity impairment
• COPD
• productivity
• quality of life
• smoking
• work productivity

Financial & competing interests disclosure

This study was funded by Pfizer, Inc. J Chapnick and J Vietri are employees of Kantar Health, which received funding from Pfizer, Inc. to perform this analysis of the NHWS database. A Galaznik, G Makinson, S Tripathi and K Zou were employed by Pfizer, Inc. at the time of this study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Editorial assistance was provided by Helen Jones, PhD, of Engage Scientific and was funded by Pfizer, Inc.

Key issues

• • Both smoking and chronic obstructive pulmonary disease (COPD) are known to impact health-related quality of life (HRQoL), work productivity and healthcare resource use.

• • Smoking cessation is one of the interventions for COPD for which there is evidence to support an improvement in lung function.

• • This survey-based study was conducted to investigate the burden of smoking, as assessed by patient-reported HRQoL and productivity metrics, on individuals who suffer from COPD, by comparison of patients who were current smokers at the time of the survey with patients who had quit smoking (0–5 years, 6–10 years and ≥11 years prior to completing the survey).

• • The results suggest that patients with COPD who were current smokers had lower HRQoL compared with those who had quit ≥11 years prior to completing the survey.

• • There was a trend for current smokers with COPD who were employed to have increased productivity losses compared with those who had quit smoking ≥11 years prior to completing the survey, losing approximately 31% of their total productivity to health issues.

• • Indirect costs associated with productivity lost to presenteeism were significantly higher for current smokers compared with those who had quit smoking ≥11 years prior to completing the survey.

• • Patients with COPD who had quit smoking for <11 years had HRQoL and productivity outcomes that were similar to those of current smokers.

• • In addition to the health benefits of improved lung function and reduced mortality, the results of this study highlight the gains in areas of everyday QoL and productivity that can be obtained by patients with COPD if they quit smoking.

Notes