Problems of managing smoking patients with a pulmonological profile in real outpatient settings

Introduction. Smoking is a leading risk factor for the development of chronic bronchitis, chronic obstructive pulmonary disease (COPD), cardiovascular pathology, cancer, diabetes mellitus. The main role in helping smoking patients and identifying their respiratory pathology in outpatient practice belongs to the primary care physicians The paper analyzes the problems of managing smoking patients with a pulmonological profile in real outpatient practice, shows the need for psychological support for patients during the period of quitting smoking.

Purpose. To identify signs of bronchoobstructive syndrome in smokers, assessment of smoking status, formation of tobacco cessation groups, analysis of routing of patients with respiratory complaints in real outpatient practice.

Material and methods. In state institutions of the Kalinsky district of St. Petersburg, screening examinations were conducted for smoking women and men of working age with an average socio-economic status. The examination was completed by 140 smoking patients aged 20 to 60 years, including 41 men (average age 43.5-+) and 67 women (45.9+1.1 years). In addition to the questionnaire, all subjects underwent spirometry and determination of CO (ppm) in exhaled air.

Results. Women started smoking later than men. The number of cigarettes smoked per day, the smoking index, and the degree of nicotine dependence in women were significantly lower, which was naturally accompanied by a significantly lower content of CO in the exhaled air. Bronchoobstructive syndrome was detected in 56% of men and 40% of women; the degree of nicotine dependence and respiratory symptoms were interrelated only in women (r = 0.50, p < 0.01). With almost identical levels of motivation to quit smoking and the number of attempts to get rid of tobacco dependence, the duration of abstinence from smoking in women turned out to be more significant

Conclusion. The identified problems of managing smoking patients with a pulmonological profile in real outpatient practice dictate the need for clear routing of these patients with mandatory psychological support during the period of smoking cessation.

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