Highlights from ERS Annual Congress 2013

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The Global Bridges Initiative was presented during tobacco sessions of the European Respiratory Society Annual Congress. During the discussion, attendees acknowledged the existing gap and a global need in fostering smoking cessation as a public health strategy to tackle the tobacco epidemic.

COPD Worldwide and Tobacco Facts

Joan B. Soriano, Director of Epidemiology and Clinical Research of Fundación Caubet-Cimera, demanded more attention be paid to tobacco control issues during the ERS Annual Congress – the world´s largest respiratory meeting. During his lecture, “A Worldwide Update of Prevalence of COPD,” he pointed out that four of the five leading causes of death in 2010 were caused by smoking and noted that smoking topics were noticeably underrepresented in the sessions.

Maria Montes de Oca, president of Asociacion Latinoamericana del Torax, emphasized seven to eight COPD cases found in population-based studies worldwide are underdiagnosed and therefore without therapeutic or preventive interventions.

Bartolome R. Celli of the Pulmonary and Critical Care Medicine Division at the Brigham and Women’s Hospital-Harvard University, said that while reviewing indexes to evaluate COPD severity, he summarized that the risk of death from cigarette smoking conditions are now nearly identical for men and women. Although male lung cancer mortality had plateaued in the 1980s, there is no explanation for COPD continuously increasing for all-cause tobacco-related mortality in women, and that smoking cessation at any age dramatically reduced all death rates.

COPD Exacerbation Incidence Decreased with Smoke-Free Environment

Desmond, F. et al, offered the first report of a reduction of COPD exacerbation in relation to a 100% smoke free policy. The analysis revealed a 22% drop of COPD exacerbation incidence in Graubunder’s canton two years after a ban on indoor smoking. In comparison, COPD exacerbation incidence decreased seven percent in the rest of Switzerland’s cantons where indoor smoking was allowed. The difference was not only statistically but clinically significant and on par with previous reports of a reduction of myocardial infarction in the same period of time.

All Switzerland cantons became 100% smoke free in in 2010, thus more data will be forthcoming.

E-Cigarette Controversies

11Sept2013-blog100-photo2Perspectives about e-cigarettes differed in the tobacco sessions. A randomized controlled study compared e-cigarettes with nicotine, nicotine patches, and placebos. A University of Auckland in New Zealand study by Bullen, C. et al, of the use of e-cigarettes among 657 smokers presented preliminary results. The study showed a similar rate of six-month continuous abstinence for all groups (7, 3%, 5, 8% and 4, 1%) but a higher percent of cigarette consumption (57%, 41% and 45%).

Another presentation highlighted the scarce knowledge of e-cigarettes among a sample of primary care providers. Jones, G. et al, from Aintree University Hospital surveyed 139 healthcare providers from Liverpool and the surrounding area and observed that more that 60% considered e-cigarettes as an adjuvant in SC. Additionally, although more than 70% recognized them as more harmful than cigarettes, almost half of them answered that is not safer than nicotine replacement therapy.

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A third poster revealed the acute effects of e-cigarettes. These devices used propylene or polyethylene glycol-based liquids. Palamidas, A.F. et al, from Athens University explored the acute effect on airways resistance after 10 minutes of e-cigarette consumption with and without nicotine in normal and obstructive patients. Raw and Gaw was modified suggesting a non-nicotine mediated effect in both groups.

About the author: Gustavo Zabert, MD, is the Global Bridges Regional Director for Latin America. A trainer, educator, and pulmonologist, Zabert is also the director at Carrera de Especialista en Neumología Escuela de Medicina and Profesor Asociado at Universidad Nacional del Comahue.