# Investigation of smoking cessation intention and the associated factors in patients diagnosed with chronic obstructive pulmonary disease: A cross-sectional study

## TL;DR

This study explores what influences COPD patients' intention to quit smoking, finding that being married, knowing cessation methods, and having quit intentions are key factors.

## Contribution

The study introduces a new scale to assess smoking cessation intention in COPD patients and identifies significant predictors using the GOLD 2023 staging system.

## Key findings

- Being married is significantly associated with higher smoking cessation intention scores.
- Knowledge about smoking cessation methods is linked to increased intention to quit.
- GOLD stage A is associated with lower cessation scores in COPD patients.

## Abstract

Intention to quit is an important early step and a strong predictor of smoking cessation success. In this study, individuals with chronic obstructive pulmonary disease (COPD) were evaluated with a newly developed scale for patients' intention to quit smoking using the current COPD staging system.

This cross-sectional study was conducted in Gaziantep, Turkey, from 1 March to 1 December 2024, and included 160 people with COPD who currently smoke, to investigate factors associated with smoking cessation intention using a questionnaire. Patients attending the chest diseases outpatient clinic were evaluated through face-to-face interviews using a structured questionnaire assessing demographic, clinical, and disease-specific measures. Shortness of breath was assessed using the modified Medical Research Council (mMRC) score, and COPD symptoms were evaluated using the COPD Assessment Test (CAT). COPD staging was performed according to the Global Initiative for Obstructive Lung Disease (GOLD) 2023 guidelines. Additionally, the Fagerström test for nicotine dependence and the Smoking Cessation Intention Scale were employed. GOLD staging (A, B, E) was defined as: GOLD A (≤1 non-hospitalized exacerbation, mMRC 0–1, CAT <10); GOLD B (mMRC ≥2 and/or CAT ≥10); and GOLD E (≥2 moderate or ≥1 hospitalized exacerbations).Descriptive statistics, non-parametric tests (Mann-Whitney U and Kruskal-Wallis), and Spearman’s rho correlation were used. In addition, generalized linear regression model (GLM) was applied.

The mean age of the patients was 59.43 ± 10.54 years; 148 patients (92.5%) were male, and 104 patients (65%) had primary education. A weak but significant positive correlation was found between the Smoking Cessation Scale scores and both CAT (r=0.245, p=0.002) and mMRC scores (r=0.164, p=0.039). Lower cessation scores were significantly associated with single status (p=0.009), no quit attempts in the last year (p<0.001), lack of information about smoking cessation methods (p=0.016), absence of intention to quit smoking (p<0.001), lack of knowledge that smoking causes heart disease (p=0.035), and GOLD stage A (p=0.001). In the multivariate GLM analysis conducted with eight variables that were found to be significantly associated with the smoking cessation intention score in univariate analyses, three factors remained statistically significant: being married compared to being single (B=4.958; 95% CI: 1.203–8.714, p=0.010), having knowledge about smoking cessation methods compared to not having such knowledge (B=2.432; 95% CI: 0.192–4.672, p=0.033), and having the intention to quit smoking compared to lacking such intention (B=3.327; 95% CI: 1.117–5.536, p=0.003).

Physicians should assess quit-smoking intention factors in COPD patients who continue smoking and should consider these factors in cessation interventions and referrals.