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Group I (no smoking cessation or influenza vaccination), Groups II (influenza vaccination only), Group III (smoking cessation only) and Group IV (both smoking cessation and influenza vaccination) Figure 3 Odds ratios analysis of emergency utilization, hospital utilization, and respiratory failure in Groups II (influenza vaccination only), Group III (smoking cessation) and Group IV (both smoking cessation and influenza vaccination), compared to Group I (no smoking cessation or influenza vaccination), in addition, non-parametric tests for trend on emergency utilization, hospital utilization, and the occurrence of respiratory failure DISCUSSION Our study demonstrates that the combination of smoking cessation and influenza vaccination has synergistic effects in reducing the medical burden of COPD
