Reversibility of pulmonary function abnormalities in smokers. A prospective study of early diagnostic tests of small airways disease

Abstract

A prospective study of the reversibility of pulmonary function abnormalities in cigarette smokers was performed. Base line studies of 50 otherwise healthy cigarett smokers included lung volumes, static volume-pressure curves, closing volume, slope of phase III and maximum expiratory flow-volume curves while the subjects breathed air and while they breathed an 80 per cent helium-20 per cent oxygen mixture (He). Ten subjects, seven women and three men, ages 29 to 61, were restudied 6 to 14 weeks after they had stopped smoking. Two of these people had an abnormal closing volume, four had an abnormal slope of phase III and five had an abnormal response to helium. Static volume-pressure curves, slope of phase III and airflow rates were not improved on the repeat studies. There was increases in maximum expiratory flow rates with He at 50 and 25 per cent of vital capacity, reductions in the lung volume at which the maximum expiratory flow rate of air and He became identical, and decreases in closing volume. These reversible functional changes in smokers are thought to indicate improvement of peripheral airways obstruction.