Am. J. Respir. Crit. Care Med., Vol 151, No. 5, May 1995, 1393-1400.
Effects of cigarette smoking on lung function in four population samples in the People's Republic of China. The PRC-US Cardiovascular and Cardiopulmonary Epidemiology Research Group
AS Buist, WM Vollmer, Y Wu, R Tsai, LR Johnson, S Hurd, CE Davis, OD Williams, Y Li and B Chen
Oregon Health Sciences University, Portland 97201-4867, USA.
As part of an ongoing study of cardiopulmonary risk factors in the People's
Republic of China, we conducted lung function tests and obtained
information about smoking habits on 6,765 Chinese men and women 35 to 56 yr
of age residing in or around Beijing in the north and in or around
Guangzhou in the south. Within each region, separate urban and rural
populations were recruited. This study examined the relationship between
tobacco consumption (both manufactured cigarettes and leaf tobacco) and
lung function in a subset of current smokers and never smokers who had
acceptable lung function data. All methods were strictly standardized.
Overall, tobacco smoking was associated with a statistically significant
mean difference in FEV1 among men (-89 ml) and women (-52 ml) relative to
never smokers after adjusting for age, height, and residence. Differences
between smokers of cigarettes and smokers of leaf tobacco were not
significant. Among the subset of smokers who smoked only cigarettes, this
decrement increased with increasing duration of cigarette smoking, but it
was small (-4 ml/yr of smoking for FEV1 for both men and women) in
comparison with the effects of smoking reported from western countries.
Although the smoking effect tended to increase with increasing dose, these
differences were small and generally not statistically significant. The
relatively small smoking effect in this study may result from differences
between developed and developing countries in the cumulative dose of
tobacco products. Alternative explanations or contributing factors such as
racial differences in susceptibility and differences in the form and
delivery of tobacco cannot be discounted.
