The Variable Effect of Smoking on Pulmonary Function

¹ Assistant Professor of Medicine; Chief, Cardiopulmonary Laboratory, Albert Einstein College Hospital
² Department of Medicine, Albert Einstein College of Medicine, New York City

The variable effect of cigarette smoking in producing airway obstruction was evaluated in 925 subjects who were tested in a respiratory disease screening program. There were 589 smokers who were divided into four groups by pack-year exposure. The flow rates in the 1-20 pack-year group were indistinguishable from those in nonsmokers. With increasing cigarette exposure there was a progressive reduction in mean flow rates and an increase in the incidence of severe obstruction. Nevertheless, a significant number of heavy smokers remained within normal limits. Thus, in the 20-40, 40-60 and 60+ pack-year groups, the FEV₁/VC was within normal limits in 58 percent, 45 percent and 29 percent of subjects and the MMF was within normal limits in 40 percent, 38 percent and 21 percent of subjects, respectively. The highly variable individual susceptibility to the of cigarette smoking would seem to inmply that other genetic and environmental factors are also operative in the production of airway obstruction. Idetification of these additional factors would permit recognition of a high risk population for preventive health purposes.

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