Introduction: Even though smoking has decreased significantly over the last few years, the majority of Icelanders 40 years of age or older have a history of smoking. Limited information is available on respiratory symptoms and diagnosis of chronic obstructive lung diseases (COPD) in this group.

Material and methods: During a four week period at the Akureyri Primary Care Center all individuals above the age of 40 were given a questionnaire on smoking, respiratory symptoms and medical treatment. There were a total of 416 individuals and the response rate was 63%. Spirometry was done on those who had smoked.

Results:  Of the 259 responders, 150 (57,9%) had a history of smoking. In this group 117 (45,2%) had quit  but 33 (12,7%) were still smoking.  Of those that had a history of smoking 16% had COPD according to spirometry results and 2/3 did not have a previous diagnosis. Respiratory symptoms were more common with increasing obstruction. Of the smokers 26% had never been advised by a physician to stop smoking. A total of 14,3% of the whole group had a previous diagnosis of emphysema, chronic obstructive pulmonary disease or chronic bronchitis. Altogether 23,5% had previously been diagnosed with asthma, asthmatic bronchitis or allergic bronchitis.

Conclusion: A history of smoking was common among the primary care patients. One in six who had a smoking history were found to have COPD and the majority were unaware of the diagnosis. Respiratory diagnoses were common. By spirometric evaluation many smokers are diagnosed with previously unknown COPD.

Clarke GD¹, Jonsson JS^2,3, Olafsson M¹, Joelsdottir SS⁴,Gudmundsson G^3,5

¹Akureyri Primary Care Center, ²Gardabaer Primary Care Center, ³Faculty of Medicine University of Iceland, ⁴University of Akureyri, ⁵Department of Respiratory Medicine National University Hospital.

Figure 1. Age distribution and smoking. The figure shows the age distribution and the number of those who have never smoked, have quit smoking or are still smoking for both men and women.

Figure 2. Relative prevalence and number of those who have COPD according to age and sex among spirometry participants (%).

Figure 3. Distribution analysis of symptoms of cough, mucous production and dyspnea of those with a normal spirometry compared to individuals with GOLD stages I-III.