title: Accelerated decline in lung function in smoking women with airway obstruction: SAPALDIA 2 cohort study.
abstract: BACKGROUND
  The aim was to determine if effects from smoking on lung function measured over 11 years differ between men and women.
  
  
  METHODS
  In a prospective population based cohort study (Swiss Study on Air Pollution and Lung Diseases in Adults) current smokers in 1991 (18-60 yrs) were reassessed in 2002 (n = 1792). Multiple linear regression was used to estimate effects from pack-years of cigarettes smoked to 1991 and mean packs of cigarettes smoked per day between 1991 and 2002 on change in lung volume and flows over the 11 years.
  
  
  RESULTS
  In both sexes, packs smoked between assessments were related to lung function decline but pack-years smoked before 1991 were not. Mean annual decline in FEV1 was -10.4 mL(95%CI -15.3, -5.5) per pack per day between assessments in men and -13.8 mL(95%CI-19.5,-8.1) in women. Decline per pack per day between 1991 and 2002 was lower in women who smoked in 1991 but quit before 2002 compared to persistent smokers (-6.4 vs -11.6 mL, p = 0.05) but this was not seen in men (-14.3 vs -8.8 mL p = 0.49). Smoking related decline was accelerated in men and women with airway obstruction, particularly in women where decline in FEV1 was three fold higher in participants with FEV1/FVC<0.70 compared to other women (-39.4 vs -12.2 mL/yr per pack per day, p < 0.002).
  
  
  CONCLUSIONS
  There are differences in effects from smoking on lung function between men and women. Lung function recovers faster in women quitters than in men. Women current smokers with airway obstruction experience a greater smoking related decline in lung function than men.
authors.affiliation: Institute of Social and Preventive Medicine, University of Basle, Basle, Switzerland. s.downs@unibas.ch
authors.forename: Sara H
authors.initials: SH
authors.lastname: Downs
authors.forename: Otto
authors.initials: O
authors.lastname: Brändli
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Zellweger
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.forename: Nino
authors.initials: N
authors.lastname: Künzli
authors.forename: Margaret W
authors.initials: MW
authors.lastname: Gerbase
authors.forename: Luc
authors.initials: L
authors.lastname: Burdet
authors.forename: Robert
authors.initials: R
authors.lastname: Bettschart
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Zemp
authors.forename: Martin
authors.initials: M
authors.lastname: Frey
authors.forename: Roland
authors.initials: R
authors.lastname: Keller
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Tschopp
authors.forename: Philippe
authors.initials: P
authors.lastname: Leuenberger
authors.forename: Ursula
authors.initials: U
authors.lastname: Ackermann-Liebrich
mesh_terms: D000293:Adolescent; D000328:Adult; D000402:Airway Obstruction / Q000175:diagnosis* / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D013557:Switzerland / Q000453:epidemiology; D013990:Tidal Volume; D013997:Time Factors