Smoking cessation programs and other preventive strategies for chronic obstructive pulmonary disease.

Introduction C obstructive pulmonary disease (COPD) is a major public health problem worldwide. It is the fourth leading cause of chronic morbidity and mortality in the United States1 and is projected to rank fifth in 2020 as a worldwide burden of disease according to a study published by the World Bank/ World Health Organization.2 Tobacco smoking is the main aetiological factor of COPD. Apart from COPD, smoking is a risk factor for other lung diseases such as pneumonia, tuberculosis, asthma, interstitial lung diseases, pneumothorax and lung cancer etc.3 The International Classification of Disease (ICD-10) has recognized that “Tobacco Dependence” is a disease.4 The medical profession especially in underdeveloped countries has not taken a serious view of the ‘disease of tobacco dependence’, and has not made serious attempts to treat the disease, ‘Tobacco Dependence’.5 In many countries, air pollution resulting from the burning of wood and other biomass fuels has been identified as a COPD risk factor.3 Occupational exposures to dusts, gases, fumes and irritants are also important risk factors for COPD. Smoking cessation is the most important strategy for the prevention and progression of COPD.6,7 A number of reviews and guidelines on smoking cessation have recently been published. They provide recommendations for interventions and strategies to promote the treatment of tobacco dependence.8-12 The current situation calls for integrating smoking cessation as a routine strategy in chest clinics. This puts an onerous responsibility on the physicians to have detailed knowledge about smoking cessation methods, and the use of medication. Others methods for COPD prevention include prevention of environmental tobacco smoke exposure and reduction of indoor and outdoor air pollutions.