MYSS: should we alter clinical practice?

4indicate that nicotine-dependent smokers are particularly prone to relapse. Second, the chance of a successful quit attempt can be decreased by the presence of psychiatric disorders. Depression is independently associated with inability to stop smoking, and results of research show that patients with COPD are at a greater risk of developing depression than individuals without COPD (unpublished data). In view of these factors, how successful are interventions used to help the general population to stop smoking when used by patients with COPD? Only five trials have assessed the efficacy of smoking cessation interventions in patients with COPD. 5 Results of the Lung Health Study 5 showed that intensive behavioural counselling combined with nicotine replacement therapy resulted in much higher 5-year abstinence rates than no intervention. Furthermore, contrary to what has been stated in many reviews, bupropion has not yet been shown to be effective in smokers with COPD. 5 However,