The Association of Socio-Economic Factors, and Smoking Behavior With COPD Severity in an Industrial City of Iran

Socioeconomic and lifestyle factors are regarded as important influencing issues regarding a wide range of chronic diseases, including chronic obstructive pulmonary disease. This study aimed to explore the role of such factors as determinants of disease exacerbation among COPD patients. A cross-sectional study was conducted among 150 COPD patients who were referred to an outpatient respiratory care center in Qazvin, Iran, to undertake respiratory function tests from December 2017 to June 2018. Disease severity was determined by the Initiative for Chronic Obstructive Lung Disease (GOLD) index. Odds ratios were applied to find out factors associated with exacerbation. Study findings affirmed that within COPD severity groups, there were significant differences among patients in terms of educational level, smoking status, income, and occupation. Factors associated with severe COPD were found to be smoking (OR 3.6, 2.6-4.2), lower education (OR 1.4, 0.9-2.6), insufficient income (OR 2.3, 0.6-3.1), and unsupportive family (2.7, 1.5-3.6). Due to the obtained evidence about the effect of socioeconomic status on the prognosis of the disease, it is suggested that clinicians should also consider the nonclinical and social aspects associated with the disease in advancing patients' therapeutic procedures and management algorithms.