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Pulmonary Disease

Answer 1
  1. Smoking cessation. Smoking cessation is the single most effective and cost-effective intervention for slowing the progression of COPD.1 Inhaled corticosteroids and ipratropium may reduce hospitalization rates in patients with moderate to severe COPD, but they failed to retard the rate of decline of FEV1 in large randomized controlled trials. It is unlikely that either of these medications has a positive impact on long-term survival in stable COPD patients. Oral corticosteroids do not benefit most patients with COPD and can cause severe adverse effects. Counseling patients to stop smoking can be an effective intervention—even a brief, 3-minute session—and, at the very least, counseling should be done for every smoker at every visit.<

    1. Anthonisen NR, Connett JE, Kiley JP, et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1. The Lung Health Study. JAMA 1994;272:1497-505.

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