title: [Influence of current smoking on adherence and responses to pulmonary rehabilitation in patients with COPD].
abstract: OBJECTIVE
  To investigate the modulating effects of current smoking on adherence and responses to pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  In a prospective study, 18 ex-smokers and 23 current smokers (GOLD stages II-III) were enrolled in a 12-week multidisciplinary, supervised PR program. The patients were assessed clinically and as to subjective variables (dyspnea and health-related quality of life) and objective variables (body composition, pulmonary function and 6-min walking distance). The degree of nicotine dependence in current smokers was assessed by the Fagerström test. Program completion defined PR 'adherence'.
  
  
  RESULTS
  There was a significant association between current smoking and non-adherence to PR with 30.4% vs. 11.1% and odds ratio=2.9 (1.6-4.1; p<0.01). However, the current smokers who completed the program (n=16) had a similar absentee rate to the ex-smokers, as well as similar gains in the subjective (quality of life) and objective (walked distance) items. Additionally, there was a significant reduction in daily cigarette consumption and in the degree of nicotine dependence in current smokers (p<0.05).
  
  
  CONCLUSIONS
  Although current smoking is negatively related to PR adherence, COPD smokers who complete the PR can have similar gains in functionality and quality of life compared to ex-smokers. Moreover, PR may be related to decreased nicotine dependence, even without a formal smoking withdrawal program.
authors.affiliation: Departamento de Fisioterapia, Hospital Municipal, Universitário de São Bernardo do Campo, São Bernardo do Campo, SP, Brasil.
authors.forename: Vivian T S
authors.initials: VT
authors.lastname: Santana
authors.forename: Selma D
authors.initials: SD
authors.lastname: Squassoni
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Neder
authors.forename: Elie
authors.initials: E
authors.lastname: Fiss
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D012907:Smoking; D016896:Treatment Outcome