Smoking and Lung Function of Lung Health Study Participants after 11 Years

Abstract

Eleven years after Lung Health Study (LHS) entry, we performed spirometry in 77.4% of surviving participants who enrolled in a long-term follow-up study. Those not enrolling tended to be younger male heavy smokers who continued to smoke during the LHS. Their initial LHS lung function, after adjustment for these factors, did not differ from that of enrollees. Smoking habits by original LHS treatment groups (smoking intervention vs. usual care) tended to converge, but 93% of participants who were abstinent throughout the LHS were still abstinent at 11 years. Differences in lung function between treatment groups persisted; smoking intervention participants had less decline in FEV(1) than usual care participants. Men who quit at the beginning of the LHS had an FEV(1) rate of decline of 30.2 ml/year, whereas women who quit declined at 21.5 ml/year. Men continuing to smoke throughout the 11 years declined by 66.1 ml/year, and women continuing to smoke declined by 54.2 ml/year. When decline in FEV(1) was expressed as a percentage of predicted normal value, no significant sex-based difference was apparent among continuing smokers. At 11 years, 38% of continuing smokers had an FEV(1) less than 60% of the predicted normal value compared with 10% of sustained quitters.

Bronchodilator response in the lung health study over 11 yrs

“…The LHS [10][11][12] was a trial of smoking cessation and bronchodilator (ipratropium) therapy in volunteer smokers aged 35-59 yrs with airway obstruction (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ,70%) who were not otherwise ill, and who had baseline values of FEV1 of 55-90% of the predicted normal [13]. Of the original 5,887 participants, .90% were followed with annual spirometry for the 5 yrs of the original study [10].…”

“…Of the original 5,887 participants, .90% were followed with annual spirometry for the 5 yrs of the original study [10]. After the original study, telephone contact was maintained with most participants, and ,11 yrs after enrollment 4,194 were re-examined, 77% of those not known to be dead [11]. Both the original 5-yr study and the 11-yr follow-up were approved by ethics committees at all participating institutions.…”

Changes in personal control as a predictor of quality of life after pulmonary rehabilitation

“…Mostly, these are unhealthy behaviours the patients have engaged in for many years and therefore these behaviours are resistant to change. For example, smoking is the most important contributing factor in the development and progression of COPD [5,11], which patients find hard to change. Therefore, it is very important for the patients to be motivated and committed to the rehabilitation programme to be able to accomplish changes in their behaviour.…”

Evaluation of clinical variables according to follow-up times in COPD: results from ON-SINT cohort

“…The impact of different treatments and specifically long-acting bronchodilators on FEV 1 decline has not been consistently demonstrated in previous high-powered clinical trials. [46] Although the relationship of tobacco with lung function decline has been well established,[47] we did not find this association. We are now starting to understand the genetic determinants that may drive this different response after quitting tobacco.…”