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Immediate Effects of Cigar Smoking on Respiratory Mechanics and FENO Among Young Smokers FREE TO VIEW

Andreas Lappas; Efstathia Konstantinidi; Anna Tzortzi; Charikleia Stathopoulou; Miltiades Vassiliou, MD; Panagiotis Behrakis, MD
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Research Centre for Smoking and Lung Cancer, Hellenic Cancer Society, Athens, Greece

Chest. 2014;146(4_MeetingAbstracts):969A. doi:10.1378/chest.1989961
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SESSION TITLE: Tobacco Cessation and Prevention Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The immediate response of respiratory system after cigar smoking is an area of interest, especially among young smokers. The purpose of the study was to detect the acute effects of cigar smoking on respiratory mechanics and exhaled nitric oxide (NO).

METHODS: 50 healthy young smokers (average age=23±4, 32 males, mean pack-years=3.6) using cigarettes and occasionally cigars, voluntarily participated in this study. 25 had mild respiratory symptoms (atopic history, mild cough and exercise induced chest tightness) and mild peripheral airways obstruction (FEF25%-75%= 74.15% pred., MRS-subgroup). The other 25 had normal dynamic flows and no respiratory complaints (NRS-subgroup). Multifrequency respiratory impedance (Zrs), resistance (Rrs), reactance (Xrs), frequency-dependence of resistance (fdr=Rrs5Hz-Rrs20Hz), resonant frequency (fres) and reactance area (AX), assessed with impulse oscillometry, and fractional exhaled nitric oxide (FENO) were measured before and immediately after, 30 minutes of cigar smoking, or equal session in the smoking area without smoking (control-group, blind control was impossible). Wilcoxon signed rank and U-Mann-Whitney rank sum tests were performed and level of significance was defined as p-value<0.05.

RESULTS: Immediately after 30 minutes of cigar smoking, Zrs5Hz, Rrs5Hz, Rrs10Hz, Rrs20Hz and meanRrs5-Rrs20 significantly increased (+8.8% to +16.61%), both in the whole population(n=50) and the two subgroups (MRS and NRS). Xrs20Hz significantly decreased in the whole population and the MRS-subgroup (-10.9% and -22.05%) but not in the NRSsubgroup. fdr significantly increased in the MRS-subgroup (+40.7%) and significantly decreased in the NRS-subgroup (-50%). Among the two subgroups, significant differences at the changes of fres and AX (+10.84% and +25.76% in MRS, -2.6% and -5.96% in NRS), were also detected. FENO was significantly decreased in the whole population (-8.27%) and the MRS-subgroup (-10.64%). In the control-group, no significant changes were detected.

CONCLUSIONS: 30 minutes of cigar smoking has immediate effects on respiratory mechanics and exhaled NO.

CLINICAL IMPLICATIONS: Mild respiratory symptoms combined with mild peripheral airways obstruction predispose to a higher increase in peripheral resistance (fdr) and higher reduction of exhaled NO. In non symptomatic subpopulation, central resistance (Rrs20Hz) is more affected and exhaled NO is not significantly altered.

DISCLOSURE: The following authors have nothing to disclose: Andreas Lappas, Efstathia Konstantinidi, Anna Tzortzi, Charikleia Stathopoulou, Miltiades Vassiliou, Panagiotis Behrakis

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