Annals of Long Term Care

The 2010 International Conference of the American Thoracic Society (ATS) was held in New Orleans, LA, May 14-19, with an international attendance of over 15,000 persons. This annual meeting of respiratory health researchers and clinicians took on additional significance since 2010 has been designated the “Year of the Lung” by hundreds of international organizations focusing on the importance of lung health and lung disease. The campaign is aimed at educating the public, elected officials, and the media about the global importance of respiratory health and the quality of the air that we breathe.

An international task group has been formed with members representing the major respiratory societies and health organizations, including the World Health Organization (WHO). The website www.2010yearofthelung.org describes how the campaign was developed and how individuals or organizations can become partners. One of the major efforts of the campaign is to get every country to ratify the WHO Framework Convention on Tobacco Control, already signed by more than 160 countries around the world. Ratifying countries agree to adopt such measures as a ban on tobacco advertising, warnings on tobacco products, initiatives to protect nonsmokers from tobacco products, and taxes to reduce tobacco consumption. One of the “Year of the Lung” campaigns in this country is the “Drive 4 COPD” program (www.drive4copd.com) sponsored by NASCAR, the American Lung Association, and other public and private organizations targeting earlier awareness and treatment of chronic obstructive pulmonary disease (COPD). It is especially focused on the “missing millions,” the estimated 12 million persons in the United States who have COPD but are not aware of it. Clearly, a major focus of the campaign is targeted at reducing tobacco consumption and improving air quality, but there are also major advocacy efforts directed at improving asthma care, eliminating tuberculosis, treating sleep disorders, and many other important problems associated with lung health.

Smoking Cessation
Smoking is a known major risk factor for respiratory disease as well as a number of other health problems, so a half-day session at the ATS meeting focused on understanding barriers to quitting and strategies to improve smoking cessation outcomes. A multicentered, multinational, controlled trial (N = 598) reported significantly better quit rates at the end of 12 weeks of treatment (53.59% vs 18.69%; P < 0.0001; odds ratio [OR], 5.76) using varenicline versus placebo with both groups receiving counseling at each visit. The quit rate was sustained better to 24 weeks in the treatment group (39.74% vs 13.13%; P < 0.001; OR, 4.78), and the treatment was well tolerated, with only a 4.1% dropout rate due to treatment-emergent side effects versus 1.5% in the placebo group.

For many persons, especially women, a significant barrier to smoking cessation is the weight gain that ensues with quitting. Researchers from Greece hypothesized that the appetite suppressant effect of nicotine could be at least partially maintained using the nicotine receptor agonist varenicline as an aid in smoking cessation. In a small study (N = 15), they demonstrated that persons using varenicline had an average weight gain of 4.18 pounds versus a weight gain of 8.8 pounds in a control group when measured four weeks after successful smoking cessation in both groups.

Another study jointly conducted by Japanese and U.S. researchers (Cincinnati, OH) compared spontaneous smoking cessation rates in two groups of smokers who were seen for annual check-ups at a health clinic. Both groups had spirometry done as a part of their examination, and one group (N = 1034) was given their spirometry results plus a calculated “lung age.” The control group (N = 988) was simply given their spirometry results as a percentage of predicted values.