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      Lack of awareness towards smoking-related health risks, symptoms related to COPD, and attitudinal factors concerning smoking: an Internet-based survey conducted in a random sample of the Danish general population

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          ABSTRACT

          Background: Although chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality globally, several studies have shown little awareness of COPD in the general population. The awareness of COPD in the Scandinavian countries is, however, sparsely investigated.

          Objective: The aim of this study was to explore the awareness in the general Danish population of smoking-related health risks and symptoms related to COPD and attitudinal factors concerning smoking.

          Design: Adults aged 18 years or older were randomly selected to reflect the background population. An Internet-based questionnaire was conducted in January–February 2015.

          Results: A total of 1002 answered the questionnaire (515 males; 487 females). In total, 17.7% were current smokers (men: 15.5%–women: 19.9%). More smokers and ex-smokers knew the symptoms of COPD compared to never-smokers ( p < 0.001). Ex-smokers had undergone more pulmonary function tests than smokers and never-smokers ( p < 0.001) and significantly more men than women who had undergone pulmonary function test.

          Ex-smokers were more likely to rate cancer as the most feared disease ( p = 0.026) than the smokers. Of the smokers, 28% did not regard COPD as a deadly disease and significantly more smokers than ex-/never-smokers believed that smoking cessation should not be mandatory before treatment of COPD and asthma ( p < 0.001).

          Conclusion: Overall, smokers, ex-, and never-smokers had little knowledge of COPD regarding aetiology, symptoms, and severity thus emphasizing the necessity of early detection of COPD and more focus on spirometry in general practice, especially amongst smokers.

          There is a great discrepancy between the attitude of smokers and ex-/never-smokers towards mandatory smoking cessation before receiving treatment of smoking-related diseases.

          Funding: GlaxoSmithKline Pharma A/S Brøndby, financially supported the collecting of data by Voxmeter A/S. The authors had full access to the raw data and did not receive any financially support.

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          Developing COPD: a 25 year follow up study of the general population.

          H Scharling, J Vestbo, A Løkke … (2006)
          Smokers are more prone to develop chronic obstructive pulmonary disease (COPD) than non-smokers, but this finding comes from studies spanning 10 years or less. The aim of this study was to determine the 25 year absolute risk of developing COPD in men and women from the general population. As part of the Copenhagen City Heart Study, 8045 men and women aged 30-60 years with normal lung function at baseline were followed for 25 years. Lung function measurements were collected and mortality from COPD during the 25 year observation period was analysed. The percentage of men with normal lung function ranged from 96% of never smokers to 59% of continuous smokers; for women the proportions were 91% and 69%, respectively. The 25 year incidence of moderate and severe COPD was 20.7% and 3.6%, respectively, with no apparent difference between men and women. Smoking cessation, especially early in the follow up period, decreased the risk of developing COPD substantially compared with continuous smoking. During the follow up period there were 2912 deaths, 109 of which were from COPD. 92% of the COPD deaths occurred in subjects who were current smokers at the beginning of the follow up period. The absolute risk of developing COPD among continuous smokers is at least 25%, which is larger than was previously estimated.
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            Not 15 but 50% of smokers develop COPD?--Report from the Obstructive Lung Disease in Northern Sweden Studies.

            Kara M. Lindstrom, L Larsson, E Rönmark … (2003)
            The prevalence of chronic obstructive pulmonary disease (COPD) according to guidelines of today seems considerably higher than has been reported also in recent literature. To estimate the prevalence of COPD as defined by British Thoracic Society (BTS) criteria and the recent global initiative for chronic obstructive lung disease (GOLD) criteria. Further aims were to assess the proportion of underdiagnosis and of symptoms in subjects with COPD, and to study risk factors for COPD. In 1996, 5892 of the Obstructive Lung Disease in Northern Sweden (OLIN) Study's first cohort could be traced to a third follow-up survey, and 5189 completed responses (88%) were received corresponding to 79% of the original cohort from December 1985. Of the responders, a random sample of 1500 subjects were invited to a structured interview and a lung function test, and 1237 of the invited completed a lung function test with acceptable quality. In ages >45 years, the prevalence of COPD according to the BTS guidelines was 8%, while it was 14% according to the GOLD criteria. The absolutely dominating risk factors were increasing age and smoking, and approximately a half of elderly smokers fulfilled the criteria for COPD according to both the BTS and the GOLD criteria. Family history of obstructive airway disease was also a risk factor, while gender was not. Of those fulfilling the BTS criteria for COPD, 94% were symptomatics, 69% had chronic productive cough, but only 31% had prior to the study been diagnosed as having either chronic bronchitis, emphysema, or COPD. The corresponding figures for COPD according GOLD were 88, 51, and 18%. In ages >45 years, the prevalence of COPD according to the BTS guidelines was 8%, and it was 14% according to the GOLD criteria. Fifty percent of elderly smokers had developed COPD. The large majority of subjects having COPD were symptomatic, while the proportion of those diagnosed as having COPD or similar diagnoses was small.
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              Effect on smoking quit rate of telling patients their lung age: the Step2quit randomised controlled trial.

              H G Parkes, Mark Griffin, R Dent … (2008)
              To evaluate the impact of telling patients their estimated spirometric lung age as an incentive to quit smoking. Randomised controlled trial. Five general practices in Hertfordshire, England. 561 current smokers aged over 35. All participants were offered spirometric assessment of lung function. Participants in intervention group received their results in terms of "lung age" (the age of the average healthy individual who would perform similar to them on spirometry). Those in the control group received a raw figure for forced expiratory volume at one second (FEV1). Both groups were advised to quit and offered referral to local NHS smoking cessation services. The primary outcome measure was verified cessation of smoking by salivary cotinine testing 12 months after recruitment. Secondary outcomes were reported changes in daily consumption of cigarettes and identification of new diagnoses of chronic obstructive lung disease. Follow-up was 89%. Independently verified quit rates at 12 months in the intervention and control groups, respectively, were 13.6% and 6.4% (difference 7.2%, P=0.005, 95% confidence interval 2.2% to 12.1%; number needed to treat 14). People with worse spirometric lung age were no more likely to have quit than those with normal lung age in either group. Cost per successful quitter was estimated at 280 pounds sterling (366 euros, $556). A new diagnosis of obstructive lung disease was made in 17% in the intervention group and 14% in the control group; a total of 16% (89/561) of participants. Telling smokers their lung age significantly improves the likelihood of them quitting smoking, but the mechanism by which this intervention achieves its effect is unclear. National Research Register N0096173751.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Eur Clin Respir J
                Journal ID (iso-abbrev): Eur Clin Respir J
                Journal ID (publisher-id): ZECR
                Journal ID (publisher-id): zecr20
                Title: European Clinical Respiratory Journal
                Publisher: Taylor & Francis
                ISSN (Electronic): 2001-8525
                Publication date Collection: 2018
                Publication date (Electronic): 14 August 2018
                Volume: 5
                Issue: 1
                Electronic Location Identifier: 1506235
                Affiliations
                [a ] Department of Respiratory Medicine and Allergology, Aarhus University Hospital , Aarhus C, Denmark
                [b ] Senior Scientific Advisor, GSK, Brøndby , Denmark
                Author notes
                CONTACT Melina Gade Sikjær Melgad@ 123456rm.dk Department of Respiratory Medicine and Allergology, Aarhus University Hospital , Nørrebrogade 44, 8000Aarhus C, Denmark
                Author information
                http://orcid.org/0000-0002-5061-5367
                http://orcid.org/0000-0002-6905-4141
                Article
                Publisher ID: 1506235
                DOI: 10.1080/20018525.2018.1506235
                PMC ID: 6095014
                SO-VID: 1608c662-fb12-41f2-8385-8e81ca1f7e9b
                Copyright © © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 02 January 2018
                Date accepted : 19 July 2018
                Date revision received : 12 July 2018
                Page count
                Figures: 1, Tables: 3, References: 33, Pages: 9
                Categories
                Subject: Research Article

                Keywords: chronic obstructive lung disease,awareness of copd,smoking,questionnaire
                Data availability:
                Keywords: chronic obstructive lung disease, awareness of copd, smoking, questionnaire

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