Screening for Chronic Obstructive Pulmonary Disease in Smoking Cessation Clinic in France.

BACKGROUND: The purpose of this study was to detect chronic obstructive pulmonary disease (COPD) among smokers seeking treatment for the first time in a smoking cessation clinic and to assess the predictors of positive screening.

METHODS: This study was based on a multicenter survey with questionnaires (Richmond, Fagerstrom, clinical signs) and spirometry miniaturized. Data were analyzed with SAS® by Pearson chi-square test, the test of analysis of variance, Spearman correlation coefficient, and multivariate logistic regression step down.

FINDINGS: 1918 patients were assessed for eligibility and only 1737 were included. The report forced expiratory volume in 1 second (FEV1/FEV6) was < 0.8 for 33.2% of smokers and < 0.7 for 7.5% of them. People with likely COPD had more dyspnea (P < 0.010) and chronic bronchitis (CB) (P < 0.010). In multivariate analysis, CB, duration of smoking history since longer than 30 years, and dyspnea significantly increased the risk of being detected as COPD. The odds ratios of the above factors were 2.9, 4.1, and 4.5, respectively.

CONCLUSION: 7.5% of smokers were likely COPD. Patient's risk factors, such as the presence of CB, smoking addiction for longer than 30 years, or dyspnea, were predictive of a positive screening for COPD.