title: Smoking: relationship to chronic bronchitis, chronic obstructive pulmonary disease and mortality.
abstract: OBJECTIVE
  To describe the recent findings concerning the relationship between smoking, chronic bronchitis, chronic obstructive pulmonary disease and mortality.
  
  
  RESULTS
  During their lifetime, over 40% of smokers develop chronic bronchitis. Chronic bronchitis is associated with an accelerated decline in lung function - a risk of developing chronic obstructive pulmonary disease and mortality. Approximately one-quarter of smokers can be affected by clinically significant chronic obstructive pulmonary disease. The incidence of chronic obstructive pulmonary disease is also substantial in young adults. Smokers may reduce their risk of developing chronic obstructive pulmonary disease by physical activity and increase their survival by smoking reduction. In adults and the elderly population, severe chronic obstructive pulmonary disease is associated with the most rapid decline in lung function, which is, in turn, associated with chronic obstructive pulmonary disease-related hospitalization and mortality. Using a fixed forced expiratory volume in 1 s/force vital capacity ratio (0.7) to define obstruction in chronic obstructive pulmonary disease at old age is acceptable. In chronic obstructive pulmonary disease patients, the disease is still underreported on death certificates. Chronic mucus production and being a female are associated with chronic obstructive pulmonary disease mentioned on death certificates.
  
  
  CONCLUSIONS
  Chronic bronchitis is a marker identifying high-risk individuals. With respect to chronic obstructive pulmonary disease and mortality, interventions to promote smoking cessation are important to reduce these risks.
authors.affiliation: Department of Pulmonary Diseases, Kuopio University Hospital, Kuopio, Finland. Pelkonen@kuh.fi
authors.forename: Margit
authors.initials: M
authors.lastname: Pelkonen
mesh_terms: D029481:Bronchitis, Chronic / Q000209:etiology / Q000401:mortality; D014943:Global Health; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology* / Q000401:mortality*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D015996:Survival Rate / Q000639:trends