Smoking patterns in African Americans and whites with advanced COPD

Chest. 2004 Jan;125(1):15-21. doi: 10.1378/chest.125.1.15.


Background: The prevalence and mortality associated with COPD increases with age, with higher rates observed in whites than African Americans. Causes and explanations for smoking-related racial differences on the respiratory system have not been determined.

Objective: To investigate racial differences in smoking patterns and lung function in patients with advanced COPD.

Design: Retrospective record review of patients with advanced COPD.

Setting: Outpatient pulmonary clinic in a tertiary-care urban hospital.

Patients: One hundred sixty patients with advanced COPD (80 African Americans and 80 whites) referred for either lung volume reduction surgery or transplantation evaluation.

Data collection: Demographics, smoking profile, pulmonary function testing, arterial blood gases, and exercise stress tests were compared between African-American and white patients.

Results: Despite comparable pulmonary function, African Americans were younger at presentation and had lower overall pack-years of smoking than whites (58 +/- 10 years vs 62 +/- 8 years, and 44 +/- 23 pack-years vs 66 +/- 31 pack-years, respectively; p < 0.05 [mean +/- SD]). Additionally, African Americans started smoking later in life than whites (18 +/- 5 years vs 16 +/- 4 years). Similarly, women presented at a younger age and smoked less compared to men (58 +/- 9 years vs 62 +/- 9 years, and 49 +/- 28 pack-years vs 61 +/- 29 pack-years, respectively; p < 0.05), without showing any difference in lung function or exercise performance.

Conclusion: Among susceptible patients with advanced COPD, African Americans and women seem more prone to the effects of tobacco smoke than their counterparts.

Publication types

  • Comparative Study

MeSH terms

  • Black or African American / statistics & numerical data*
  • Exercise Test
  • Female
  • Humans
  • Lung Volume Measurements
  • Male
  • Middle Aged
  • Oxygen Consumption
  • Pulmonary Disease, Chronic Obstructive / ethnology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Gas Exchange
  • Respiratory Mechanics
  • Retrospective Studies
  • Smoking / adverse effects
  • Smoking / ethnology*
  • White People / statistics & numerical data*