Effective Tobacco Dependence Treatment in COPD

Mortality from noncommunicable diseases (NCDs) in the developing countries is expected to rise by more than 25% over the next 10 years.

Tobacco dependence treatment (TDT) is an important and needed intervention to reduce an expected surge in the burden of noncommunicable diseases in the Eastern Mediterranean Region (EMR) and tobacco dependence is a common risk factor for all NCDs.

Evidence clearly shows that investing in comprehensive tobacco control programs including TDT helps reduce cumulative deaths from tobacco related illnesses.

In the Second Middle East Asthma and COPD conference held in Kuwait this month, a dedicated lecture on treating tobacco dependence highlighted the importance of having health care providers be up-to-date with current concepts of TDT and the importance of providing such intervention for COPD patients.

TDT has proven to be one of the few interventions that can change the outcome of certain diseases such as COPD.

Health care providers and scientists are in constant search of a drug or an intervention that would impact the outcome of COPD and specifically improve survival.

Treating patients with COPD reduces the decline in FEV1, improves all patient-relevant symptoms associated with COPD, lowers hospital admissions and, most importantly, improves patient survival.

Improvement in mortality from COPD patients who quit smoking is attributed to the reduction in mortality from cardiovascular disorders, lung cancers and other complications.

These results are especially evident in younger patients – an important demographic in the EMR – with only mild impairment in FEV1 and who smoked more than 40 cigarettes per day –

Effective treatments

Treating tobacco dependence requires a specific set of skills in delivering cognitive, behavioral and pharmacological therapy.

Motivational interviewing is a core component that requires training and practice in order to provide tobacco dependent patients with their best chance of abstaining from smoking.

New trends in pharmacological treatments for tobacco dependence using available regimens in various combinations including high dose nicotine replacement therapy, Bupropion, Varinicline, and serotonin uptake inhibitors are being observed in practice.

However, despite the clear evidence for the feasibility and effectiveness of tobacco dependence programs, many challenges prevent such programs from gaining the right momentum in the EMR and the world.

Overcoming challenges

The lack of training of health care providers as well as the limited coverage of the cost of treatment by third party payers are clear examples of such challenges.

To address training deficiencies in the EMR, a new global collaboration between the Mayo Clinic and the American Cancer Society in the U.S. and the King Hussein Cancer Center has been one way of overcoming some of the above mentioned obstacles.

In the past two years Global Bridges for the EMR has trained more than 300 health care providers (HCPs) on how to successfully treat tobacco dependence.

More training of HCPs, as well as building a network of interested groups, is underway in an effort to combat a looming disaster caused by an epidemic of NCDs.

In a short time, Global Bridges has become a leading force in North America, Latin America, Africa and the EMR in combating tobacco and its deadly consequences.

U.S. COPD Coalition