Pulmonary Physiological Measurements in Smokers and Nonsmokers

Abstract

The lung function of 163 middle-aged military officers was studied in relation to smoking habits. The 113 habitual cigarette smokers were found to have significantly lower average ventilatory capacities and increased residual volumes as compared with 50 nonsmokers. Although most subjects in both groups were within normal range, there were significantly more smokers who demonstrated abnormal results to tests of maximum voluntary ventilation, timed vital capacity, and residual volume. Habitual smokers also admitted to chronic cough and shortness of breath with greater frequency than did nonsmokers, although the differences were not statistically significant. The authors conclude that these differences cannot be explained on any factor other than that one group smoked and the other group did not. THE BELATIONSHIP between cigarette smok¬ ing and chronic bronchopulmonary disease has been the subject of much discussion, speculation, and investigation in recent years. The frequent association between cigarette smoking and the syn¬ dromes of chronic cough, bronchitis, and pulmonary emphysema has been noted and reported.1"7 We are From the Department of Pulmonary Disease, USAF Hospital Scott. Dr. Hensler is now at the USAF Hospital Wiesbaden, APO 633, New York.The contents of this paper reflect the personal views of the authors and are not to be construed as a statement of official Air Force policy. aware of an increasing interest in the pulmonary physiological effect of long-term use of tobacco among healthy individuals,8'14 and studies have invariably showed decreased physiological measure¬ ments in smokers. We have recently had the oppor¬ tunity to evaluate ventilatory function and long volume in a group of middle-aged military officers in connection with their annual physical examina¬ tions. The results of these tests are assessed in relation to the patients' smoking habits. Material and MethodsSubjects were senior Air Force officers, aged 38 to 57, approximately 55% of whom were flying per¬ sonnel (pilots, navigators, and so on). Subjects were hospitalized on the evening prior to testing. A complete medical history and physical examina¬ tion was accomplished by an internist, and signifi¬ cant cardiac or pulmonary disease was excluded on the basis of history and physical findings, chest x-ray, electrocardiogram, and double Masters exer¬ cise test. In order to eliminate any acute effects of smoking, we asked the subjects to refrain from smoking, beginning at bedtime on the day prior to testing. Excellent cooperation was obtained. On reporting to the pulmonary function laboratory at 11:00 am, each subject answered a brief question¬ naire relative to past and present respiratory dis¬ ease, symptoms, and smoking habits. For the pur¬ poses of analysis of results, those individuals who habitually smoked cigarettes at the time of exami¬ nation were classified as smokers, and those who had never smoked or who had smoked only very occasionally in the past were classified as non-Downloaded From: http://jama.jamanetwork.com/ by...

Effect of Smoking on Pulmonary Mechanics and Ventilation in Young Healthy Males

“…T o us th e reaso n fo r these differences is n o t clear. R e d u c tio n o f lu n g v o lu m es a n d v e n tila to ry c ap acities in sm okers w as r e p o rte d b y n u m e ro u s a u th o rs [1,4,5,9,13,14,20,22,23]. A n aly sis o f th e ir d a ta rev eals th a t a sig n ifican t decrease is to be fo u n d o n ly fo r g ro u p s w ith a long sm o k in g h isto ry [9,13,22,23].…”

Pulmonary Function in Young Smokers: Male-Female Differences1,2

“…We believe that abnormalities in the terminal portion of the forced expiratory maneuver, which are reflected in both FEV 3 /FVC% and FEV X / FVC% (He-0 2 ), constitute simple and sensitive variables for the assessment of small-airway function. In a study of middle-aged, asymptomatic, air force officers, Hensler and co-workers (16) showed that FEV 3 /FVC% was the most sensitive spirometric index that separated smokers from nonsmokers. From our study, it was particularly noteworthy that female smokers did not exhibit significant evidence of small-airway dysfunction.…”

A Contribution to the Epidemiology of Chronic Bronchitis

“…It is assumed that chronic hypersecretion of bronchial mucus leads to an increased airway resistance, to bronchial obstruction and eventually to emphysema. Some authors demonstrate (14,20,33) changes in mechanical ventilation and in lung volumes already in young smokers.…”