Study of role of nicotine dependence in assessing the severity of chronic obstructive pulmonary disease in chronic smokers
Dr. G Vikas Naik, Dr. Sudharani P Naik
Chronic obstructive pulmonary disease continues to be a major cause of morbidity and mortality worldwide. Developing countries like India have a predominant population of unskilled labourers with poor socioeconomic status contributing to nicotine dependence. Majority subjects in our study were in age group of 25-34 years; with 63% of subjects were unskilled labourers. Nicotine dependence and severity of COPD were assessed through the Fagerstrom test score, Nicotine dependence severity scale, GOLD staging of COPD. The results showed, there was significantly higher Fagerstrom test score among COPD group compared to control by 2 score points indicating higher nicotine dependence among COPD cases as per Fagerstrom scores. The increase in severity of COPD in terms of FEV1 was significantly associated with Fagerstrom test score (r=0.385, p<0.0001). Fagerstrom test score was also significantly associated with other form of severity of COPD, St George severity scoring total St George scoring (r=0.41, p<0.0001), impact component (r=0.41, p<0.0001), activity component (r=0.39, p<0.0001), symptom component (r=0.41, p<0.0001). Fagerstrom test score is significantly correlated with COPD assessment Test, r=0.3, p=0.02. There was no statistically significant association between Fagerstrom test score category of nicotine dependency with severity of COPD as per GOLD guidelines.