The effect of pulmonary rehabilitation on smoking and health outcomes in COPD patients

Objectives Although several positive effects of pulmonary rehabilitation (PR) are known in COPD patients, the results of PR in smoker COPD patients are unclear. We aimed to compare the effect of PR on smoking behaviour and health outcomes between COPD patients who are smoker and ex-smoker. Methods In our study; 62 COPD patients (31 of them active smoker and 31 of them were ex-smoker) who completed in an 8-week outpatient PR programme were included. Pulmonary function test, blood gas analysis, mMRC Dyspnoea Scale, 6-minute walk test, St. George's Respiratory Questionnaire, SF-36 Quality of Life Questionnaire and Hospital Anxiety Depression Scale were performed. Smoking behaviour and nicotine dependence of the study group was evaluated. Results At baseline assessment; TLCO was found to be lower in the currently smoking group (p = 0.042) and significantly increased after PR (p = 0.012). FEV1, PaO2, arterial saturation, 6-min walk distance and quality of life improved in both groups (p < 0.05). Anxiety score decreased in both groups; depression score decreased only in the ex-smoker group. When comparing changes between groups; mMRC score was observed to be decreased more in the smoker group (p = 0.01). At the end of the programme, nicotine dependence score and the daily number of cigarettes were significantly decreased in the smoker group (p < 0.001), also 2 patients completely quit smoking. Conclusion Smoker COPD patients benefited from the PR programme at least as much as the patients who do not smoke. Furthermore, nicotine dependence and amount of cigarette decreased in smoker patients. Therefore, COPD patients who smoke should be referred to the PR programmes.