Cigarette Smoke Weakens COPD Medications

Retail clinicians have yet another reason to encourage their patients to quit smoking, as exposure to cigarette smoke was recently found to reduce the effectiveness of certain chronic obstructive pulmonary disease (COPD) medications.

A new study published inClinical Scienceevaluated the efficacy of salbutamol, a beta₂adrenergic agonist designed to help patients breathe by diluting their airways. Although the drug is commonly used to alleviate COPD flair-ups, its evidenced-based effectiveness in treating diseases linked to smoking—including COPD—has been relatively limited.

In order to better understand this loss of responsiveness, a research team examined sections of lung tissue that had been exposed to cigarette smoke and assessed the effect of salbutamol on this tissue, comparing it with the effect of the drug on healthy lung tissue.

The researchers determined that lung tissue exposed to cigarette smoke was less responsive to salbutamol than tissue that wasn’t.

“There is a clear need for new therapies that can overcome the limitations of current drugs used to treat COPD and associated flare-ups,” said senior study author Ross Vlahos, PhD, in a press release. “When combined with knowledge gained through clinical research, animal models utilizing cigarette smoke exposure are a valuable tool in the quest to identify new therapies for this life-changing condition.”

Interestingly, exposure to a version of the influenza A virus also reduced the lung tissue’s responsiveness to the COPD medication.

“The findings of this study suggest that cigarette smoke and respiratory virus infections may impair the ability of salbutamol to effectively bronchodilate the airways,” wrote Sebastian Johnston, a professor at Imperial College London, in an accompanying editorial. “These findings emphasize yet again that smoking is bad for you, and especially so if you have asthma or COPD.”

Retail clinicians can play an important role inhelpingsmokers kick the habit for good.

Bill Blatt, MPH, director of tobacco programs for the American Lung Association,previouslyoffered the following suggestions for providers looking to encourage smoking cessation:

• Use any clinic visit as an opportunity to ask patients whether or not they smoke, and emphasize the importance of quitting if they do.
• Recommend the use of a smoking cessation medication currently available in the United States, including 5 OTC nicotine replacement products (patches, gum, inhalers, nasal sprays, and lozenges) and 2 prescription drugs: Pfizer’s varenicline (Chantix) and GlaxoSmithKline’s bupropion (Zyban).Monitor the effectiveness of smoking cessation medications in patients taking such drugs.Work with pharmacists to ensure that there are no interactions between currently prescribed medications and either smoking cessation drugs or the tobacco product itself.
• Refer patients to a hotline available in each state (1-800-QUIT-NOW) that can provide support and direct patients to additional local resources.

Retail clinicians can also educate patients about thehealth benefitsassociated with smoking cessation.

For example, quitting tobacco can decrease a patient’s risk of coronary heart disease within 1 to 2 years and reduce a patient’s risk of lung cancer by 50% after 10 years. Smoking cessation has also been linked with improved circulation and lung function, as well as lower risk for COPD, stroke, peripheral vascular disease, and premature death.