Nicotine dependence and physical function: a comparison between current smokers with and without chronic obstructive pulmonary disease who seek cognitive-behavioral therapy

Smoking is a chronic disease characterized by nicotine dependence that affects the physical and mental health of millions of people worldwide. This study compared the degree of nicotine dependence, general fatigue, lung function, functional exercise capacity (FEC), and quality of life (QoL) in smokers with and without chronic obstructive pulmonary disease (COPD) who were seeking cognitive-behavioral therapy (CBT). This cross-sectional study involved 53 smokers (27 in the COPD group and 26 in the noCOPD group). Participants underwent a FEC assessment using the Glittre-ADL test (TGlittre), as well as pulmonary function analysis via spirometry and impulse oscillometry (IOS) to detect small airway disease (SAD). Participants also completed the following assessments: the Fagerström test for nicotine dependence (FTND), the Richmond test for motivation to quit smoking, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, and the Short Form 36 (SF-36). When the two groups were compared, the noCOPD group had a slightly higher median FTND and Richmond test scores, though the differences were not statistically significant (p=0.537 and p=0.449, respectively). The COPD group showed lower values for all evaluated parameters (p≤0.008), but no difference was detected between the groups regarding IOS. SAD was present in 74% of COPD group participants and 73% of noCOPD group participants, with no statistically significant difference (p=0.934, Cramer's V=0.01). Participants with COPD took longer to complete the TGlittre tasks (p=0.011). There were no significant differences between the groups on the FACIT-F scale (p=0.964) or the SF-36, except for the "physical functioning" domain, which was worse in the COPD group (p=0.018). In conclusion, individuals seeking CBT exhibit a high degree of nicotine dependence, regardless of COPD status. SAD is detected in approximately three-quarters of these individuals, regardless of COPD status. Furthermore, low FEC is more common in people with COPD, though general fatigue and QoL are impaired in smokers with and without COPD.

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