Underlying Values and Preferences:
This recommendation places high value on the benefits of smoking cessation for all individuals. In particular, it is the only evidence-based intervention that improves COPD prognosis by mitigating lung function decline and reduces symptoms. Although the effect and evidence for smoking cessation in the prevention of acute exacerbations of COPD are low, evidence supports smoking cessation for many reasons: smokers with mild COPD who produce cough and phlegm achieve substantial symptom reductions in the first year after smoking cessation with less lung function decline and less symptoms upon sustained cessation; cigarette smoking may be associated with infections such as pneumonia; among other general health benefits. The benefit from smoking cessation outweighs the risks, and a myriad of strategies have been summarized by other guidelines and reviews. In general, effective smoking cessation programs include behavioral, physiologic, and psychologic components comprising an acknowledgment of current smoking followed by advice to quit, pharmacologic therapies (nicotine replacement therapy, antidepressants, nicotine receptor modifier therapy), and counseling (in-person or telephone counseling), with cessation rates ranging from 8.8% to 34.5%. Smoking cessation that includes counseling and pharmacologic interventions are cost-effective.
Underlying Values and Preferences:This recommendation places high value on the benefits of smoking cessation for all individuals. In particular, it is the only evidence-based intervention that improves COPD prognosis by mitigating lung function decline and reduces symptoms. Although the effect and evidence for smoking cessation in the prevention of acute exacerbations of COPD are low, evidence supports smoking cessation for many reasons: smokers with mild COPD who produce cough and phlegm achieve substantial symptom reductions in the first year after smoking cessation with less lung function decline and less symptoms upon sustained cessation; cigarette smoking may be associated with infections such as pneumonia; among other general health benefits. The benefit from smoking cessation outweighs the risks, and a myriad of strategies have been summarized by other guidelines and reviews. In general, effective smoking cessation programs include behavioral, physiologic, and psychologic components comprising an acknowledgment of current smoking followed by advice to quit, pharmacologic therapies (nicotine replacement therapy, antidepressants, nicotine receptor modifier therapy), and counseling (in-person or telephone counseling), with cessation rates ranging from 8.8% to 34.5%. Smoking cessation that includes counseling and pharmacologic interventions are cost-effective.
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