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Am. J. Respir. Crit. Care Med., Volume 161, Number 2, February 2000, 381-390

Smoking Cessation and Lung Function in Mild-to-Moderate Chronic Obstructive Pulmonary Disease
The Lung Health Study

PAUL D. SCANLON, JOHN E. CONNETT, LANCE A. WALLER, MURRAY D. ALTOSE, WILLIAM C. BAILEY, A. SONIA BUIST, and DONALD P.TASHKIN for th e Lung Health Study Research Group

Division of Pulmonary and Critical Care Medicine, Mayo Foundation, Rochester, Minnesota; Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota; Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia; Veterans Hospital, Case Western Reserve University, Cleveland, Ohio; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Alabama School of Medicine, Birmingham, Alabama; Department of Veterans Affairs Medical Center, Birmingham, Alabama; Department of Medicine and Physiology, Oregon Health Sciences University, Portland, Oregon; and Division of Pulmonary and Critical Care Medicine, Department of Medicine, UCLA School of Medicine, Los Angeles, California

Previous studies of lung function in relation to smoking cessation have not adequately quantified the long-term benefit of smoking cessation, nor established the predictive value of characteristics such as airway hyperresponsiveness. In a prospective randomized clinical trial at 10 North American medical centers, we studied 3,926 smokers with mild-to-moderate airway obstruction (3,818 with analyzable results; mean age at entry, 48.5 yr; 36% women) randomized to one of two smoking cessation groups or to a nonintervention group. We measured lung function annually for 5 yr. Participants who stopped smoking experienced an improvement in FEV1 in the year after quitting (an average of 47 ml or 2%). The subsequent rate of decline in FEV1 among sustained quitters was half the rate among continuing smokers, 31 ± 48 versus 62 ± 55 ml (mean ± SD), comparable to that of never-smokers. Predictors of change in lung function included responsiveness to beta -agonist, baseline FEV1, methacholine reactivity, age, sex, race, and baseline smoking rate. Respiratory symptoms were not predictive of changes in lung function. Smokers with airflow obstruction benefit from quitting despite previous heavy smoking, advanced age, poor baseline lung function, or airway hyperresponsiveness. Scanlon PD, Connett JE, Waller LA, Altose MD, Bailey WC, Buist AS, Tashkin DP, for the Lung Health Study Research Group. Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease: The Lung Health Study.




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