Published ahead of print on June 23, 2006, doi:10.1164/rccm.200603-422OC Am. J. Respir. Crit. Care Med., Volume 174, Number 8, October 2006, 853-857 A more recent version of this article appeared on October 15, 2006
Submitted on March 24, 2006 Small Airways Function Improvement after Smoking Cessation in Smokers without Airway ObstructionSylvia Verbanck1*,1 Respiratory Division, Vrije Universiteit Brussel, Academic Hospital, Brussels, Belgium, 2 Biomedical Physics Laboratory, Universite Libre de Bruxelles, Brussels, Belgium * To whom correspondence should be addressed. E-mail: sylvia.verbanck{at}az.vub.ac.be.
Objective: Studying smokers with normal spirometry requires monitoring tools of the peripheral lung. A validated multiple breath washout technique was used to assess possible recovery of smoking-induced small airways malfunction in acinar and conductive lung zones. Methods: Eighty seven smokers with a smoking history of at least 10packyears but absence of spirometric airflow obstruction were invited for assessment of lung function and small airways function at baseline, and after 1week, 3months, 6months and 12months of smoking cessation. A control group of 16 persistent smokers was studied over the same time intervals. Measurements and main results: Of the 87 smokers, 66%, 32%, 28% and 21% succeeded smoking cessation for 1week, 3months, 6months and 12months, respectively. Lung function parameters remained essentially unaffected by smoking cessation. Ventilation heterogeneity showed transient improvements after 1week in the acinar lung compartment with a return to baseline afterwards. By contrast, there were persistent improvements in the conductive airway compartment, e.g.,smokers who successfully quit smoking for 12months (n=18) showed a 30% and 42% reduction of conductive airways abnormality after 1week and 1year,respectively. Conclusions: Smokers with early signs of small airways malfunction who successfully quit smoking, show sustained improvements of conductive airway malfunction. In contrast, acinar airways malfunction quickly returns to baseline after a transient improvement. Key words: smoking cessation, small airways, phase III slope, ventilation distribution, multiple breath washout.
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