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Editorials |

Do We Really Want To Know Why Only Some Smokers Get COPD?

Grant W. Waterer, MD, FCCP; Suzanna E. Temple, PhD
Author and Funding Information

Affiliations: Perth, WA, Australia
 ,  Dr. Waterer is Senior Lecturer in Medicine, and Dr. Temple is Research Fellow, School of Medicine and Pharmacology, University of Western Australia.

Correspondence to: Grant W. Waterer, MD, FCCP, Senior Lecturer in Medicine, School of Medicine and Pharmacology, University of Western Australia, GPO Box X2213, Perth, WA, Australia 6847; e-mail: waterer@cyllene.uwa.edu.au



Chest. 2004;125(5):1599-1600. doi:10.1378/chest.125.5.1599
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To the never-ending annoyance of physicians trying to convince their patients to quit smoking, nearly everyone knows of someone who “smoked cigarettes all their life” and never had any smoking-related health problems. In the past, the fact that not everyone who smoked cigarettes predictably acquired cigarette-related diseases undoubtedly helped perpetuate the notion that smoking had not been “proven” to cause cardiovascular or respiratory disease.

Although there is a clear relationship to total life-time cigarette consumption, in the case of COPD, cross-sectional and longitudinal studies of regular cigarette smokers show only approximately 20% acquire significant airflow limitation.12 Potential explanations for why some cigarette smokers acquire chronic airways disease but not others include genetic differences in inflammatory and repair processes and/or modulation of these responses by infections or other environmental insults at prenatal, early childhood, or adult stages.3

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