Cigarette smoking decreases dynamic inspiratory capacity during maximal exercise in patients with type 2 diabetes

To investigate the influence of cigarette smoking on exercise capacity, respiratory responses and dynamic changes in lung volume during exercise in patients with type 2 diabetes. Forty-one men with type, 2 diabetes without cardiopulmonary disease were recruited and divided into 28 non-current smokers and 13 current smokers. All subjects received lung function tests and cardiopulmonary exercise testing using tracings of the flow-volume loop. Exercise capacity was compared using the percentage of predicted oxygen uptake at maximal workload (%VO2max). Respiratory variables and inspiratory capacity (IC) were compared between the two groups at rest and at 20%, 40%, 60%, 80% and 100% of maximum workload. Although there was no significant difference in lung function tests between the two groups, venous carboxyhemoglobin (CO-Hb) levels were significantly higher in current smokers. %VO2max was inversely correlated with CO-Hb levels. Changing patterns in respiratory rate, respiratory equivalent and IC were significantly different between the two groups. Current smokers had rapid breathing, a greater respiratory equivalent and a limited increase in IC during exercise. Cigarette smoking diminishes the increase in dynamic IC in patients with type 2 diabetes. As this effect of smoking on dynamic changes in lung volume will exacerbate dynamic hyperinflation in cases complicated by chronic obstructive pulmonary disease, physicians should consider smoking habits and lung function when evaluating exercise capacity in patients with type 2 diabetes.     

Respiratory effects of non-tobacco cigarettes

Data from the Tucson epidemiological study of airways obstructive disease on smoking of non-tobacco cigarettes such as marijuana were analysed to determine the effect of such smoking on respiratory symptoms and pulmonary function. Among adults aged under 40, 14% had smoked non-tobacco cigarettes at some time and 9% were current users. The prevalence of respiratory symptoms was increased in smokers of non-tobacco cigarettes. After tobacco smoking had been controlled for men who smoked non-tobacco cigarettes showed significant decreases in expiratory flow rates at low lung volumes and in the ratio of the forced expiratory volume in one second to the vital capacity. This effect on pulmonary function in male non-tobacco cigarette smokers was greater than the effect of tobacco cigarette smoking. These data suggest that non-tobacco cigarette smoking may be an important risk factor in young adults with respiratory symptoms or evidence of airways obstruction.     

哮喘患者与健康吸烟者肺部HRCT扫描对比研究

目的初步探讨哮喘患者、健康吸烟者及正常无吸烟志愿者肺部HRCT扫描中空气潴留的分布情况及呼气、吸气末肺容积之比。方法对30例哮喘患者,15例健康吸烟者及15例正常无吸烟者行肺部吸气末及呼气末HRCT扫描,并行肺功能检查,重点观察呼气末空气潴留象、呼气末与吸气末肺容积之比。结果哮喘组、健康吸烟组、无吸烟组所观察到空气潴留个数分别为12．5±3．2、3．5±0．6、3．2±0．7,呼气末肺容积与吸气末肺容积之比分别为0.67±0．21、0．58±0．12、0．56±0．10,两组数据哮喘组与健康吸烟组及无吸烟组比较皆具有统计学差异,健康吸烟组与无吸烟组比较统计学上无显著性差异。结论空气潴留在哮喘患者及健康人肺部HRCT中皆有出现,但在哮喘患者肺部出现频度较高,健康吸烟者与健康无吸烟者两组肺功能皆正常,空气潴留出现频度较低。     

Ventilatory standards for clinically well aboriginal adults.

OBJECTIVE: To obtain reference standards for ventilatory function of clinically well Australian Aboriginal adults. DESIGN: A cross-sectional assessment of the population of a North Queensland Aboriginal community. SETTING: A specialist clinical and public health service. The measurements were made with the cooperation of the local primary health care centre. PARTICIPANTS: The 288 study subjects included over 70% of Aboriginal adults residing in an isolated Cape York community. Those with known respiratory disease, abnormal chest x-ray findings, positive loose cough sign, abnormal lung signs or inability to perform the ventilatory tests satisfactorily were excluded; 229 persons (80%) remained for analysis. Smoking was prevalent in both men (85%) and women (76%). As in most other studies producing reference values for lung function, smokers were not excluded. MAIN OUTCOME MEASURES: Age, standing height in bare feet and sitting height were recorded. Ventilatory measurements included forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and maximum mid-expiratory flow (MMEF) which is also known as the forced expiratory flow (FEF 25%-75%). RESULTS: Standing height, age and sex were the major determinants of ventilatory function. Sitting height was not a good predictor. Ventilatory values differed significantly from those expected for Europeans: Aboriginal lung volumes were much smaller (by about 25%) and fell much faster with age. The age-related decrease in lung function was less in smokers. CONCLUSION: The smoking effect may reflect the operation of differential survival or other selective factors and has been noted in some other ethnic groups. Although previous studies have yielded some ventilatory function data on Aborigines, we report the first population-based reference values expected for clinically well adults. The information will be useful to clinicians and public health workers.     

Chronic airflow obstruction. Evolution of disordered function in cigarette smokers

Measurements of the mechanical behaviour of the lung, which reflect lung structure, have been used to elucidate the evolution of chronic airflow obstruction in male cigarette smokers and subjects with pulmonary emphysema. The exponent K, from a single exponential function fitted to static pressure-volume data, is an index of lung distensibility directly related to the size of peripheral airspaces. Elastic recoil pressure is inversely related to K. Conductance measured during forced and interrupted deflations of the lungs reflects the dimensions of airways. K increased abnormally with age in smokers suggesting an increase in the airspace size caused by the effects of cigarette smoke which probably acts by intensifying elastase activity in lung tissue. Decreased conductance implying narrowing of airways is found in young smokers, but conductance rises and airways become more distensible in older smokers. A progressive increase in K (with decrease in recoil pressure) and a decrease in conductance are responsible for the advancement of severe airflow obstruction in cigarette smokers.     

The effect of cigarette smoking on hemoglobin levels and anemia screening

The relationships among cigarette smoking, hemoglobin concentration, and carboxyhemoglobin concentration were examined using data from the Second National Health and Nutrition Examination Survey. Among women, smokers had a mean (+/- SE) hemoglobin level of 137 +/- 0.4 g/L, significantly higher than the mean hemoglobin level of 133 +/- 0.5 g/L for never-smokers. Among men, the mean hemoglobin levels for smokers and never-smokers were 156 +/- 0.4 and 152 +/- 0.5 g/L, respectively. No significant difference in mean hemoglobin was noted between ex-smokers and never-smokers. Mean hemoglobin levels and carboxyhemoglobin levels increased progressively with the number of cigarettes consumed per day. Cigarette smoking seems to cause a generalized upward shift of the hemoglobin distribution curve, which reduces the utility of hemoglobin level to detect anemia. Among women of comparable socioeconomic status, the prevalence of anemia was 4.8% +/- 0.6% among smokers, compared with 8.5% +/- 1.2% among never-smokers. This study suggests that minimum hemoglobin cutoff values should be adjusted for smokers to compensate for the masking effect of smoking on the detection of anemia.     

Transfer factor in smokers and non-smokers after smoking two cigarettes

Impairments of lung functionality as long-term effects of cigarette smoking have been well established. To our knowledge, no study on acute recovery patterns in any important lung function index after smoking a very limited number of cigarettes has ever been reported. The present study reports recovery patterns of lung transfer factor (TF) and related parameters in smokers and non-smokers who smoked two Camel cigarettes. Lung transfer factor and other indices were determined by the single breath-holding technique. From our results, the TF and related indices of healthy Malaysians are similar to previously published normals of comparable age. On smoking two cigarettes, male smokers began to recover from the 30th minute; male non-smokers had not begun recovery even by the 50th minute. Extrapolation of the recovery curves suggests that a "safer" interval between cigarettes for male smokers is about 114 minutes.     

Active and passive smoking and pathological indicators of lung cancer risk in an autopsy study.

OBJECTIVE. The association between involuntary smoking and lung cancer has been supported by most epidemiologic studies, but a number of authors and interest groups claim that the possibility of bias has not been excluded. Few autopsy-based studies have explored the role of active smoking and other exposures in lung carcinogenesis, and none has been previously done to examine the role of passive smoking. We have undertaken such an autopsy-based study in Athens, Greece. DESIGN. Lung specimens were taken at autopsy from 400 persons 35 years of age or older, of both genders, who had died within 4 hours from a cause other than respiratory or cancer in Athens or the surrounding area. For each person at least seven tissue blocks were taken from the main and lobar bronchi and at least five blocks from the parenchyma, including an average of about 20 smaller cartilaginous bronchi and membranous bronchioles. The specimens were examined without knowledge of the exposures of the particular subject in Turin, Italy. For 283 (71%) of the subjects the preservation of the bronchial epithelium was satisfactory for pathological examination, and for 206 among them (73%) an interview could be arranged with their next of kin, focusing on smoking habits of the deceased and their spouses, as well as other variables. The interviewers were not aware of the results of the pathological examinations. MAIN OUTCOME MEASURE. Specimens were examined for basal cell hyperplasia, squamous cell metaplasia, cell atypia, and (in membranous bronchioles and bronchiolo-alveolar airways) mucous cell metaplasia, ie, pathological entities that may be lung cancer risk indicators or epithelial, possibly precancerous, lesions (EPPL). The gland and wall thicknesses were also measured and their ratio calculated (Reid Index). RESULTS. In comparison with nonsmokers, EPPL values were significantly higher among current smokers and higher, but not significantly so, among former smokers. Furthermore, EPPL values were significantly higher among deceased nonsmoking women married to smokers rather than to nonsmokers. In this set of data neither occupation nor residence was associated with EPPL, but this could be due to the poor correlation of residential history with exposure to air pollution and the lack of adequate standardization of contemporary Greek occupations. The Reid Index was higher among smokers and former smokers in comparison with nonsmokers, among subjects with mainly urban residence in comparison with those with mainly rural residence, and among nonsmoking women married to smokers in comparison with those married to nonsmokers, but none of these differences was statistically significant. CONCLUSION. These results provide support to the body of evidence linking passive smoking to lung cancer, even though they are based on a study methodologically different from those that have previously examined this association.     

Cigarette smoke induced oxidative insult in local population of Pokhara.

Objectives: To assess the effect of cigarette smoking on lipid peroxidation induced oxidative stress, antioxidants, uric acid and blood sugar in normal subjects. Methods: The study included 61 normal subjects with regular smoking habit and 57 never-smokers normal subjects matched in respect to socio-economic status, age and BMI. Information regarding smoking habit and other personal details were collected by oral questionnaire. Total antioxidant activity (TAA), reduced glutathione (GSH), alpha-tocopherol (alpha-T), ascorbic acid (AA), uric acid (UA), plasma and urinary thiobarbituric acid reactive substances (TBARS), fasting blood sugar (FBS) and urinary creatinine (Cr) were estimated by standard procedures in both the groups. Ferric Reducing Antioxidant Power (FRAP) procedure is used to estimate TAA which measures total dietary antioxidants. Statistical analysis was done with SPSS version 10. Results: The mean pack years smoked by smokers was 14.4 +/- 15.8. The plasma TBARS level in smokers and never-smokers was 2.6 +/- 0.8 and 2.5 +/- 0.6 micromol/L respectively. The respective figure for urinary TBARS level was 4.6 +/- 2.7 and 3.7 +/- 1.4 micromol/gmCr. Smokers did not show any significant difference from never-smokers with respect to GSH, alpha-T, AA, plasma TBARS and FBS. However, the smokers had significantly lower levels of TAA (p<0.05) and raised level of urinary TBARS (p<0.05) and uric acid (p<0.01) as compared to never-smokers. Conclusion: Our study suggests that smoking induces mild lipid peroxidation but the body is able to compensate for it by removing its adducts. Importantly it also indicates enhanced oxidation of purines which are essential components of both DNA and RNA. Dietary antioxidants are consumed to scavenge free radicals (FR) and other reactive species (RS) in smoke. Female smokers are more prone to oxidative insult than male smokers. In summary RS present in smoke induce mild lipid peroxidation but are not the major contributors of redox imbalance in smoke induced toxicity in the selected subjects. Key words: Tobacco, Smoking, Free radicals, Oxidative stress, Antioxidants.     

Effects of ��-adrenergic blockade and stimulation on airways in normal subjects

The effects of propranolol and salbutamol on conventional pulmonary function tests and closing volume have been studied in ten normal subjects. Propranolol and salbutamol had minor effects on measurements of airways resistance but had no effect on closing volume which is particularly sensitive to changes in peripheral airways. It was concluded that propranolol had negligible overall effect on central and peripheral airways properties in normal subjects, and it would appear that β-adrenergic activity has little measurable influence on peripheral airways in normal man at rest.     

Effect of 2-5 years of tobacco smoking on ventilatory function tests

Smoking is a pernicious scourge of the world today. There is paucity of literature on the effect of acute smoking on ventilatory functions. The present work is undertaken to study the effect of 2-5 years of tobacco smoking on ventilatory functions. The study group consisted of 30 male, young, healthy subjects, free from cardiopulmonary diseases and with history of smoking of 2-5 years duration, on an average of 10 cigarettes per day. The control group consisted of 30 age-and sex-matched healthy individuals who had naver smoked tobacco. The ventilatory function tests were carried out using electronic spriolyser. There was a significant lowering of the following parameters in smokers: Vital capacity (VC), inspiratory reserve volume (IRV), inspiratory capacity (IC), forced vital capacity (FVC), forced expiratory volume at the end of first second (FEV1), maximum midexpiratory flow (MMEF), peak expiratory flow (PEF), midexpiratory flow75 (MEF75), maximum voluntary ventilation (MVV). This study shows that 2-5 years of tobacco smoking leads to a definite tendency to narrowing of both the large and the small airways.     

Impacts of Preoperative Smoking and Smoking Cessation Time on Preoperative Peripheral Blood Inflammatory Indexes and Postoperative Hospitalization Outcome in Male Patients with Lung Cancer and Surgery Treatment

ObjectivesTo investigate the effects of preoperative smoking and smoking cessation time on preoperative peripheral blood inflammatory indexes and postoperative hospitalization outcomes in male patients with lung cancer and surgery therapy.MethodsWe retrospectively enrolled 637 male patients who underwent curative-intent lung cancer resection between January 2014 and December 2016. Patients were classified as the current smokers, the never smokers, and the ex-smokers based on their smoking history, and the ex-smokers were allocated into five subgroups according to their smoking cessation times (CeT): CeT < 6 weeks, 6weeks<CeT ≤ 1year, 1year<CeT ≤ 5years, 5years<CeT ≤ 10years, CeT>10years. The preoperative peripheral blood white blood cells (WBCs), albumin, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), intraoperative blood loss, 30-day mortality, in-hospital days, hospitalization costs, intensive care unit (ICU), admission days and placement time of closed thoracic drainage tube were compared among different groups.ResultsThere were significant differences in WBC (F = 5.275, P<0.001) and albumin (F=2.470, P<0.05) among patients of current smokers, ex-smokers with different smoking cessation time, and never-smokers. The blood WBC count in current smokers (7.7 × 10⁹/L) was significantly higher than that in ex-smokers (7.0 × 10⁹/L) and never-smokers (5.9 × 10⁹/L) (t = –2.145, P<0.05; t = –6.073, P<0.01, respectively). The level of peripheral blood albumin in current smokers (41.1 g/L) was lower than that in ex-smokers (42.1 g/L) and never-smokers (43.2 g/L) (t = 2.323, P<0.05; t = 3.995) P<0.01, respectively). The level of peripheral blood NLR in current smokers (3.7) was higher than that in ex-smokers (3.1) and never smokers (2.8) (t = –1.836, P<0.05; t = –2.889, P<0.01, respectively). There was no significant difference in WBC, albumin and NLR among five subgroups of different smoking cessation time. No significant difference was observed in intraoperative blood loss, 30-day mortality, hospitalization costs, hospital stay, ICU stay and placement time of closed thoracic drainage tube among groups either.ConclusionSmoking increases the preoperative inflammatory indexes in peripheral blood of lung cancer patients. Smoking cessation has beneficial effect on reducing levels of these inflammatory indexes, which may be not impacted by the time length of smoking cessation. Therefore, lung cancer patients should be encouraged to quit smoking at any time.     

Association between household and workplace smoking restrictions and adolescent smoking

CONTEXT: Recent marked increases in adolescent smoking indicate a need for new prevention approaches. Whether workplace and home smoking restrictions play a role in such prevention is unknown. OBJECTIVE: To assess the association between workplace and home smoking restrictions and adolescent smoking. DESIGN, SETTING, AND SUBJECTS: Data were analyzed from 2 large national population-based surveys, the Current Population Surveys of 1992-1993 and 1995-1996, which included 17,185 adolescents aged 15 to 17 years. MAIN OUTCOME MEASURES: Smoking status of the adolescents surveyed, compared by presence of home and workplace smoking restrictions. RESULTS: After adjusting for demographics and other smokers in the household, adolescents who lived in smoke-free households were 74% (95% confidence interval [CI], 62%-88%) as likely to be smokers as adolescents who lived in households with no smoking restrictions. Similarly, adolescents who worked in smoke-free workplaces were 68% (95% CI, 51%-90%) as likely to be smokers as adolescents who worked in a workplace with no smoking restrictions. Adolescent smokers were 1.80 (95% CI, 1.23-2.65) times more likely to be former smokers if they lived in smoke-free homes. The most marked relationship of home smoking restrictions to current adolescent smoking occurred in households where all other members were never-smokers. Current smoking prevalence among adolescents in homes without smoking restrictions approached that among adolescents in homes with a current smoker but with smoking restrictions. CONCLUSIONS: Parents with minor children should be encouraged to adopt smoke-free homes. Smoke-free workplaces can also augment smoking prevention. These findings emphasize the importance of tobacco control strategies aimed at the entire population rather than at youth alone. JAMA. 2000;284:717-722     

Passive cigarette smoking and patients with asthma

A study of the effect of passive smoking on patients with asthma is presented. Six patients were exposed for one hour to the air in a room in which tobacco smoke was produced mechanically over that period. The effects on symptoms, lung function and airways sensitivity to inhaled histamine were then measured and compared with the same patient's responses during a control day when they inhaled smoke-free air. All six patients developed chest tightness and symptoms similar to an attack of asthma. The findings of respiratory and sensitivity tests suggest: (i) that passive smoking may trigger asthma attacks in subjects who suffer from asthma and (ii) that the airways of such subjects show increased histamine reactivity four hours after the passive smoke exposure.     

吸烟对健康者肺功能的影响

目的：研究吸烟对人体肺功能的影响,提高人们早期戒烟意识。方法：应用MedGraphics 1085D肺功能仪（美国）对我院体检中心161例健康成年人进行肺功能检测,探讨吸烟对肺功能的影响。结果：吸烟组中FEV1、FVC、FEV1/FVC明显低于对照组（P〈0.05）;小气道功能指数FEF50%、FEF75%、MMEF显著降低（P〈0.01）。结论：健康吸烟者肺通气功能较非吸烟者有不同程度的下降,且以阻塞性通气功能及小气道功能损害为主;肺功能检查对气道疾病早期诊断具有重要意义。     

Another smoking hazard: raised serum IgE concentration and increased risk of occupational allergy

Individual smoking histories of a general population sample and of two groups of workers exposed to occupational allergens were related to serum IgE concentrations and results of radioallergosorbent and prick tests in the workers. The geometric mean IgE concentration was higher in smokers than in non-smokers. The distribution of serum IgE values in the two groups showed an apparent difference, with a bimodal appearance in the smokers. Evidence of sensitisation against occupational allergens was more common in workers who smoked. The adjuvant effect of smoking on IgE antibody production might be due to damage to airways mucosa and supports the mucosal theory of atopy.     

退休煤矿工人肺功能动态观察

目的研究退休煤工尘肺患者肺通气功能损害及其变化规律。方法对某矿36名退休煤工人分别于2005年和2010年进行通气功能测定和高仟伏胸片拍摄。结果动态分析结果显示煤矿退休工人吸烟人数百分比由2005年25%增加到2010年66.67%,2010年用力肺活量(FVC)和第1秒时间肺活量(FEV1)平均值均和占预计值百分比与2005年相比差异无统计学意义,而2010年反应小气道功能的指标FEF50和FEF75平均值和占预计值百分比与2005年相比均有统计学意义。肺功能障碍以Ⅱ期煤工尘肺肺功能损伤明显,2010年与2005年比大气道功能障碍人数没有增加,小气道功能损伤增加7例。结论 5年期间,退休煤矿工人小气道功能明显降低,认为其小气道功能损伤是粉尘、吸烟和年龄多重因素作用的结果,小气道功能检查对评价退休煤矿工人的呼吸功能很重要。     

辽宁省六城市7515名吸烟人群的肺功能检测分析

目的 通过检测吸烟人群与非吸烟人群的肺功能,探讨吸烟对肺功能的影响.方法 对辽宁省6个城市26 324人采用统一问卷调查及体格检查,经筛选和剔除后,对无症状的7 515名吸烟者及6 469名非吸烟者进行问卷调查后的6个月内,由固定技师每隔2个月应用同型号肺功能仪检测肺功能,连续3次,取均值,并对测定结果进行比较分析.结果 吸烟组与非吸烟组间以及轻、中、重组间的功能残气量(ERV)、残气量(RV)、深吸气量(IC)、肺活量(VC)、RV/肺总量(TCL)的差异均无统计学意义(P值均＞0.05).肺通气功能比较:吸烟组的1秒钟用力呼气容积(FEV1)占预计值百分比、FEV1/用力呼气肺活量(FVC)占预计值百分比均较非吸烟组显著降低(P值均＜0.05),而MVV占预计值百分比和FVC占预计值百分比的差异均无统计学意义(P值均＞0.05);轻、中、重组间MVV占预计值百分比和FVC占预计值百分比的差异均无统计学意义(P值均＞0.05),而轻组与重组间FEV1占预计值百分比、FEV1/FVC占预计值百分比的差异均有统计学意义(P值分别为＜0.01、0.05),中组与重组间FEV1:占预计值百分比的差异有统计学意义(P＜0.05).吸烟组反应小气道功能[25%呼气流速(FEF 25%)、50%呼气流速(FEF 50%)、75%呼气流速(FEF 75%)、中段呼气流速(MMEF)]的各项指标均较非吸烟组显著增高(P值分别＜0.05、0.01);轻组与重组间FEF 25%、FEF 50%、FEF 75%的差异均有统计学意义(P值均＜0.05),轻组与重组间MMEF的差异有统计学意义(P＜0.01).结论 吸烟者在尚无临床症状时,其肺通气功能已降低,随着吸烟年限和数量的增加,肺功能的损害也越严重.     

Respiratory impairment induced by smoking in children in secondary schools

A longitudinal study was carried out from 1975 to 1979 in a cohort of 405 secondary school children. At yearly intervals they underwent a series of tests of pulmonary function designed to monitor lung development; some of these tests are relatively sensitive indicators of early abnormalities. A self administered questionnaire provided details of smoking habits and respiratory symptoms. The prevalence of smoking increased with age; most of those smoking at 16 had already been smoking, at least experimentally, at 13. Taking up smoking was clearly associated with the early onset of cough, production of phlegm, and shortness of breath on exertion. After two years of smoking more than a few cigarettes a day the children who smoked appeared considerably less healthy than their non-smoking peers and showed some evidence of early obstruction of the airways.     

石棉肺病人16排螺旋CT肺功能与常规肺通气功能检查相关性分析

目的：分析CT肺功能成像与常规肺通气功能检查间的相关性。方法：选择I期石棉肺患者40例,均接受螺旋CT肺功能检查及常规肺通气功能检查,两种检查间隔不超过1周,计算并分析石棉肺患者肺容积参数与常规肺通气功能容积参数的相关性及像素指数与常规肺通气功能指标相关性。结果：（1）石棉肺患者CT肺容积参数吸气末肺容积（Vin）与肺通气功能参数最大肺容量（TCL）、呼气末肺容积（Vex）与残气量（RV）及第1秒用力肺活量占肺活量的百分比（FEV1／FVC％）、（Vin—Vex）与用力肺活量（FvC）及残气量,最大肺容量（RV／TLC）、vex/Vin与RV、FVC及RV／TLC间具有明显正相关性（P〈0．01）。（2）吸气相及呼气相石棉肺患者像素指数（PI-910及PI-950）与常规肺通气功能指标（FEV1及FEV1／FVC％）间均具有较好的负相关性,其中呼气相相关性更好。结论：CT肺功能成像与常规肺通气功能检查间具有良好的相关性,可以反应I期石棉肺患者肺通气功能情况。