Longitudinal analysis of the effects of smoking onset and cessation on pulmonary function

Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):591-7. doi: 10.1164/ajrccm.149.3.8118623.


We examined the effects of smoking onset and cessation on FEV1 in participants in the Tucson Epidemiological Study of Airways Obstructive Disease 18 yr of age or older who reported a change in smoking habits during 17 yr of follow-up. Subjects were classified as "new quitters" (n = 288) and "new starters" (n = 45) at each survey on the basis of questionnaire responses concerning current smoking habits. The pulmonary function data were analyzed using a mixed longitudinal or random effects model (REM). We compared FEV1 before and after changing smoking habits in the same subjects while adjusting for important covariables such as height, pack-years, and respiratory symptoms and diseases. The results for smoking cessation showed a beneficial effect related to quitting that was largest for younger subjects and decreased linearly with age. For women, quitting resulted in an improvement in FEV1 of 4.3% at 20 yr of age which decreased to 2.5% by 80 yr of age. Men had an improvement of only 1.2% at 20 yr of age and no improvement at 80 yr of age. After excluding subjects with low initial function (FEV1/FVC in the lowest quartile) and those with only a single observation after quitting, men (n = 70) showed a significantly higher FEV1 improvement of 4% at 20 yr of age that decreased linearly to zero by age 80 yr. In contrast, women in this subgroup (n = 89) had nearly the same degree of improvement at all ages. The onset results showed mean FEV1 values after starting smoking that were higher at the younger ages (< 23 yr) and that decreased more rapidly with age, compared with nonsmoking mean estimates, in both sexes.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arizona / epidemiology
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume*
  • Humans
  • Least-Squares Analysis
  • Linear Models
  • Longitudinal Studies
  • Lung Diseases, Obstructive / classification
  • Lung Diseases, Obstructive / diagnosis*
  • Lung Diseases, Obstructive / epidemiology
  • Lung Diseases, Obstructive / etiology*
  • Lung Diseases, Obstructive / physiopathology
  • Male
  • Middle Aged
  • Sex Factors
  • Smoking / adverse effects*
  • Smoking Cessation*