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Tobacco Cessation and Prevention: Smoking and Health |

The Effects of Smoking on Pulmonary Function Testing FREE TO VIEW

Joshua Sill, MD
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Eastern Virginia Medical School, Norfolk, VA


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A591. doi:10.1016/j.chest.2016.02.617
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SESSION TITLE: Smoking and Health

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Saturday, April 16, 2016 at 05:15 PM - 06:15 PM

PURPOSE: Much of our knowledge regarding the impacts of cigarette smoking on lung function stems from the landmark 1977 article by Fletcher and Peto, which evaluated longitudinal spirometry results in 792 men. Since then, the link between smoking and lung disease has been firmly established. However, few large studies exist, examining the relationship between smoking and pulmonary function in normal individuals.

METHODS: The U.S. Air Force School of Aerospace Medicine regularly conducts medical examinations on both trained aircrew and flight school applicants. As part of a complete medical evaluation, many flyers with no history of lung disease are required to undergo pulmonary function testing (PFTs). Information regarding smoking habits is collected at the time of pulmonary function testing. We conducted a review of U.S. Air Force aviators who had PFTs performed between 1968 and 2012. We compared performance on pulmonary function testing to smoking history, in terms of total number of pack years of cigarette exposure.

RESULTS: A total of 15,837 PFTs were completed. 14,628 sets of PFTs were included in the final analysis. This included 6,785 PFTs on current or former smokers (average 18.7 pack-years) and 7,843 PFTs on lifelong non-smokers. The ages ranged from 17-74 years (mean 40.2). 98% were male, and 96% were Caucasian. 14,415 sets of PFTs contained spirometry, while 9,353 had lung volume and 8,970 had diffusion capacity measurements.

CONCLUSIONS: Cigarette use was associated with worsening of all spirometric parameters and diffusion capacity, in a dose-dependent fashion. While total lung capacity and functional residual capacity were not greatly affected, cigarette use was associated with an increase in residual volume. All correlations were highly statistically significant.

CLINICAL IMPLICATIONS: Even in a population of young, relatively healthy individuals, cigarette smoking appears to have negative impacts on spirometry, lung volumes, and diffusion capacity.

DISCLOSURE: The following authors have nothing to disclose: Joshua Sill

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