Tratamiento del tabaquismo en pacientes con enfermedad pulmonar obstructiva crónica

Abstract

In COPD patients, smoking worsens lung function and smoking cessation reduces the fall in FEV1 and all-cause of mortality. There is a high percentage of these patients who continues smoking despite the disease due to the high degree of dependence, low motivation to quit and association with depression and false beliefs, which hampers attempts to stop smoking and reduce their success. The smoker 's treatment has two pillars: psychosocial intervention and pharmacological treatment. In COPD patients ' psychosocial intervention should be especially intense, empathic and aimed at increasing motivation and self-efficacy, using Motivational Interviewing. In pharmacotherapy, first-line drugs are nicotine replacement (NRT), bupropion and varenicline. In patients with COPD, NRT is effective and may be combined passive delivery NRT with other active delivery. Bupropion has been used, with cost-effectiveness. Varenicline in patients with mild to moderate COPD has been effective. In brief therapies for smokers with COPD should be more intense, combining pharmacological and psychosocial treatment and maintained over time.