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Please note: Cigarettes carry health risks

Severe COPD exacerbation was defined as hospitalization or emergency room visit with one of the following ICD-10 codes as the principal or secondary diagnosis: COPD (J43.X [except J43.0] or J44.X), COPD-related disease (pneumonia [J12.XJ17.X], pulmonary thromboembolism [I26, I26.0, or I26.9], dyspnea [R06.0], or acute respiratory distress syndrome [J80]), and a prescription for systemic steroids or antibiotics at the same visit [26]

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However, this unexpected result may be due to selection bias of study subjects as well as to the fact that the immunocompromised cohort consisted of subjects with a heterogeneous disease background 30

This relationship is also likely to impact on the prevalence of smoking in people with poor mental health because smoking is strongly associated with socioeconomic deprivation and can itself exacerbate socioeconomic deprivation