Accelerated decline in lung function in smoking women with airway obstruction: SAPALDIA 2 cohort study.
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.
Downs
Sara H
SH
Institute of Social and Preventive Medicine, University of Basle, Basle, Switzerland. s.downs@unibas.ch
Brändli
Otto
O
Zellweger
Jean-Pierre
JP
Schindler
Christian
C
Künzli
Nino
N
Gerbase
Margaret W
MW
Burdet
Luc
L
Bettschart
Robert
R
Zemp
Elisabeth
E
Frey
Martin
M
Keller
Roland
R
Tschopp
Jean-Marie
JM
Leuenberger
Philippe
P
Ackermann-Liebrich
Ursula
U
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