Cardiorespiratory and immune response to physical activity following exposure to a typical smoking environment

Heart. 2010 Jun;96(11):860-4. doi: 10.1136/hrt.2009.190744.


Objective: Millions of non-smokers suffer daily passive smoking (PS) at home or at work, many of whom then have to walk fast for several minutes or climb a few sets of stairs. We conducted a randomised single-blind crossover experiment to assess the cardiorespiratory and immune response to physical activity following PS.

Design: Data were obtained from 17 (eight women) non-smoking adults during and following 30 minutes of moderate cycling administered at baseline and at 0 hour, 1 hour and 3 hours following a 1-hour PS exposure set at bar/restaurant PS levels.

Results: We found that PS was associated with a 36% and 38.7% decrease in mean power output in men and women, respectively, and that this effect persisted up to 3 hours (p<0.05). Moreover, at 0 hour almost all cardiorespiratory and immune variables measured were markedly reduced (p<0.05). For instance, FEV(1) values at 0 hour dropped by 10.2% in men and 10.8% in women, while IL-5 increased by 59.2% in men and 44% in women, respectively (p<0.05). At 3-hour mean values of respiratory quotient, mean power, perceived exertion, cotinine, FEV(1), IL-5, IL-6 and INFgamma in both sexes, recovery diastolic and mean arterial pressure, IL-4 and TNFalpha in men, as well as percentage predicted FEV(1) in women remained different compared to baseline (p<0.05). Also, some of the PS effects were exacerbated in less fit individuals.

Conclusion: It is concluded that 1 hour of PS at bar/restaurant levels adversely affects the response to moderate physical activity in healthy non-smokers for at least 3 hours following PS.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Biomarkers / blood
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / immunology
  • Cotinine / blood
  • Cotinine / urine
  • Cytokines / blood
  • Environmental Exposure*
  • Environmental Monitoring
  • Epidemiologic Methods
  • Epidemiological Monitoring
  • Female
  • Humans
  • Lung Diseases / etiology*
  • Lung Diseases / immunology
  • Male
  • Peak Expiratory Flow Rate / immunology
  • Restaurants
  • Tobacco Smoke Pollution / adverse effects*
  • Vital Capacity / immunology


  • Biomarkers
  • Cytokines
  • Tobacco Smoke Pollution
  • Cotinine