Smoking And Lung Disease: Former Smokers Are Still At Risk

Despite numerous health warnings, many continue to smoke tobacco products.

New findings published in JAMA Internal reveal that nearly half of long-term smokers and ex-smokers who were once considered disease-free after passing lung-function tests actually have respiratory-related impairments when they were more closely evaluated with lung imaging, walking and other testing.

In fact, researchers found that many smokers or former smokers were actually dealing with the earliest stages of chronic obstructive pulmonary disease (COPD), the third leading cause of death in the United States estimated to affect over 12 million adults. 

For the study, they evaluated 8,872 people ages 45 to 80 who had smoked at least a pack of cigarettes a day for about 10 years; some had even smoked more. COPD was then tested by having participants blow in a spirometer that measured how much air they could blow out in one second and how much total air they could force out of their lungs. Certain factors were also adjusted in the study, including age, gender and size.

After considering other criteria, including respiratory symptoms, use of respiratory medications, CT scans, and respiratory-specific quality of life, findings revealed that roughly 55 percent of the participants who had not been diagnosed with any health problems actually had some form of respiratory related impairment.

Furthermore, the CT scans revealed emphysema or airway thickening in 42 percent of the disease-free participants; significant shortness of breath in 23 percent of participants was revealed when compared to 3.7 percent of participants who had never smoked; 25 percent of participants had questionnaire scores that exceeded a threshold considered clinically significant while 15 percent of participants walked less than 350 meers in six minutes when compared to 4 percent of never smokers.

"Smokers who have 'normal' lung-function tests often have significant respiratory disease. Many of those smokers likely have the early stages of chronic obstructive pulmonary disease," concluded Elizabeth Regan, MD, PhD, lead author and assistant professor of medicine at National Jewish Health, in a news release. "We hope these findings will help debunk the myth of the healthy smoker and highlight the importance of smoking prevention and cessation to prevent lung disease and other long-term effects of smoking."

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