Adherence and Efficacy of Smoking Cessation Treatment Among Patients with COPD in China

Figures & data

Figure 1 Flowchart of participants.

Abbreviation: ITT, intention to treatment.

Table 1 Characteristics of Participants

Characteristics	Varenicline (n=68)	Bupropion (n=68)	Total	P value
Gender				0.31
Male	67 (98.5%)	65 (95.6%)	132 (97.1%)
Female	1 (1.5%)	3 (4.4%)	4 (2.9%)
Age, y				0.69
≤55	10 (14.7%)	11 (16.2%)	21 (15.4%)
56–60	14 (20.6%)	11 (16.2%)	25 (18.4%)
61–65	24 (35.3%)	19 (27.9%)	43 (31.6%)
66–70	16 (23.5%)	20 (29.4%)	36 (26.5%)
>70	4 (5.9%)	7 (10.3%)	11 (8.1%)
Nationality				0.17
Han	67 (98.5%)	64 (94.1%)	131 (96.3%)
Non-Han	1 (1.5%)	4 (5.9%)	5 (3.7%)
Education				0.67
Primary school and below	8 (11.8%)	5 (7.4%)	13 (9.6%)
Middle school	40 (58.8%)	43 (63.2%)	83 (61.0%)
College and above	20 (29.4%)	20 (29.4%)	40 (29.4%)
Marital status				0.30
Married	67 (98.5%)	64 (94.1%)	131 (96.3%)
Divorced, widowed, and separated	1 (1.5%)	2 (2.9%)	3 (2.2%)
Unmarried	0 (0.0%)	2 (2.9%)	2 (1.5%)
Cigarettes per day				0.25
≤10	14 (20.6%)	20 (29.4%)	34 (25.0%)
11–20	38 (55.9%)	40 (58.8%)	78 (57.4%)
21–30	8 (11.8%)	3 (4.4%)	11 (8.1%)
>30	8 (11.8%)	5(7.4%)	13 (9.6%)
Duration of smoking, y				0.17
≤30	5 (7.4%)	10 (14.7%)	15 (11.0%)
31–40	24 (35.3%)	22 (32.4%)	46 (33.8%)
41–50	36 (52.9%)	28 (41.2%)	64 (47.1%)
>50	3 (4.4%)	8 (11.8%)	11 (8.1%)
FTND score				0.29
0–3	21 (30.9%)	29 (42.6%)	50 (36.8%)
4–6	23 (33.8%)	22 (32.4%)	45 (33.1%)
7–10	24 (35.3%)	17 (25.0%)	41 (30.1%)
Previous quitting attempts				0.90
None	23 (33.8%)	22 (32.4%)	45 (33.1%)
1	15 (22.1%)	18 (26.5%)	33 (24.3%)
2–3	23 (33.8%)	20 (29.4%)	43 (31.6%)
≥4	7 (10.3%)	8 (11.8%)	15 (11.0%)
Self-efficacy in quitting smoking				0.17
Weak	15 (22.1%)	11 (16.2%)	26 (19.1%)
Medium	23 (33.8%)	16 (23.5%)	39 (28.7%)
Strong	30 (44.1%)	41 (60.3%)	71 (52.2%)
Preparation in quitting smoking				0.32
Weak	14 (20.6%)	17 (25.0%)	31 (22.8%)
Medium	17 (25.0%)	10 (14.7%)	27 (19.9%)
Strong	37 (54.4%)	41 (60.3%)	78 (57.4%)
Whether recognizing hazards of smoking				0.41
Yes	13 (19.1%)	17 (25.0%)	30 (22.1%)
No	55 (80.9%)	51 (75.0%)	106 (77.9%)
Duration of COPD, y				0.09
<1	55 (80.9%)	50 (73.5%)	105 (77.2%)
1–4	4 (5.9%)	12 (17.6%)	16 (11.8%)
>4	9 (13.2%)	6 (8.8%)	15 (11.0%)
GOLD stage				0.68
Stage I	50 (73.5%)	53 (77.9%)	103 (75.7%)
Stage II	14 (20.6%)	12 (17.6%)	26 (19.1%)
Stage III	4 (5.9%)	3 (4.4%)	7 (5.1%)
Stage IV	0 (0%)	0 (0%)	0 (0%)
SGRQ
Symptom score	28.95 (23.02)	24.49 (18.34)	26.71 (20.83)	0.22
Activity score	12.20 (14.57)	11.54 (17.62)	11.87 (16.11)	0.81
Impact score	12.26 (13.68)	10.49 (14.95)	11.37 (14.30)	0.48
Total score	15.37 (14.11)	13.46 (14.23)	14.42 (14.15)	0.41

Abbreviations: FTND, Fagerstrom Test for Nicotine Dependence; COPD, chronic obstructive pulmonary disease; GOLD, Global Initiative for Chronic Obstructive Lung Disease; SGRQ, St. George’s Respiratory Questionnaire.

Figure 2 Comparison of abstinence rate between varenicline and bupropion at different time points.

Abbreviation: ECO, exhaled carbon monoxide.

Figure 3 Adherence to smoking cessation treatment and its relationship with medication use and the efficacy of smoking cessation.

Notes: (A) The overall treatment adherence; (B) the relationship between adherence to smoking cessation treatment and medication use; (C) the relationship between adherence and smoking cessation efficacy; (D) FTND Score change.

Abbreviation: FTND, Fagerstrom Test for Nicotine Dependence.

Table 2 Logistic Regression Analyses of Participants’ Characteristics to Predict Adherence

Variables	Model 1		Model 2
	(OR, 95% CI)	P value	(OR, 95% CI)	P value
Gender
Male	Ref		Ref
Female	1.28 (0.16–10.25)	0.815	1.80 (0.15–21.40)	0.643
Age, y
<56	Ref		Ref
56–60	1.96 (0.57–6.75)	0.284	1.65 (0.45–5.98)	0.448
61–65	2.39 (0.78–7.36)	0.129	1.81 (0.56–5.89)	0.325
66–70	2.80 (0.88–8.88)	0.081	2.56 (0.76–8.67)	0.130
>70	11.24 (1.85–68.24)	0.009	9.93 (1.47–67.29)	0.019
Nationality
Han	Ref		Ref
Non-Han	0.00 (0.00–0.00)	0.999	0.00 (0.00–0.00)	0.999
Education
Primary school and below	Ref		Ref
Middle school	2.14 (0.52–8.81)	0.294	1.98 (0.48–8.24)	0.347
College and above	5.52 (1.22–24.98)	0.027	5.31 (1.17–24.20)	0.031
Marital status
Married	Ref		Ref
Divorced, widowed, separated	1.64 (0.09–29.73)	0.740	2.17 (0.12–38.56)	0.597
Unmarried	0.46 (0.04–5.31)	0.531	0.64 (0.05–7.61)	0.722
Cigarettes per day
≤10	Ref		Ref
11–20	1.01 (0.43–2.38)	0.982	1.01 (0.41–2.50)	0.989
21–30	1.34 (0.32–5.56)	0.692	1.95 (0.40–9.57)	0.410
>30	0.56 (0.14–2.27)	0.413	0.75 (0.17–3.25)	0.697
Duration of smoking, y
≤30	Ref		Ref
31–40	1.62 (0.42–6.37)	0.486	1.66(0.40–6.84)	0.486
41–50	1.33 (0.34–5.23)	0.688	1.39(0.33–5.90)	0.656
>50	0.73(0.10–5.18)	0.753	1.15(0.14–9.53)	0.896
FTND score
0–3	Ref		Ref
4–6	1.26 (0.54–2.94)	0.591	1.40 (0.57–3.43)	0.467
7–10	0.53 (0.22–1.30)	0.166	0.60 (0.23–1.56)	0.294
Previous quitting attempts
None	Ref		Ref
1	0.69 (0.26–1.81)	0.448	0.77 (0.28–2.14)	0.621
2–3	0.82 (0.34–1.97)	0.650	0.65 (0.25–1.69)	0.374
≥4	5.46 (1.28–23.30)	0.022	5.17 (1.05–25.50)	0.044
Self-efficacy in quitting smoking
Weak	Ref		Ref
Medium	1.45 (0.48–4.38)	0.506	1.45 (0.47–4.51)	0.519
Strong	3.61 (1.34–9.72)	0.011	2.85 (1.02–7.95)	0.046
Preparation to quitting smoking
Weak	Ref		Ref
Medium	1.92 (0.60–6.12)	0.268	2.37 (0.70–8.00)	0.164
Strong	3.93 (1.52–10.17)	0.005	4.03 (1.45–11.19)	0.008
Whether recognizing hazards of smoking
Yes	Ref		Ref
No	0.39 (0.16–0.96)	0.040	0.37 (0.14–0.95)	0.039
Duration of COPD, y
<1	Ref		Ref
1–4	1.53 (0.47–5.03)	0.483	1.61 (0.44–5.95)	0.475
>4	5.26 (1.37–20.17)	0.015	7.09 (1.77–28.37)	0.006
SGRQ
Symptom score	1.02 (1.00–1.04)	0.022	1.03 (1.01–1.05)	0.012
Activity score	1.02 (1.00–1.05)	0.074	1.03 (1.00–1.05)	0.038
Impact score	1.04 (1.01–1.08)	0.008	1.05 (1.02–1.08)	0.004
Total score	1.04 (1.01–1.07)	0.008	1.05 (1.02–1.08)	0.003
Medication
Bupropion	Ref		Ref
Varenicline	1.07 (0.53–2.17)	0.844	1.27 (0.60–2.71)	0.537

Notes: Model 1 was adjusted for gender and age; Model 2 was adjusted for gender, age, nationality, education, and marital status.

Abbreviations: FTND, Fagerstrom Test for Nicotine Dependence; COPD, chronic obstructive pulmonary disease; SGRQ, St. George’s Respiratory Questionnaire.