EFFECT OF ACTIVE AND PASSIVE SMOKING ON VENTILATORY FUNCTION IN ELDERLY MEN AND WOMEN

Although it is well known that pulmonary function declines with age an d that this decline is accelerated by cigarette smoking, the effects o f such factors are not well established in elderly individuals. The au thors examined the effect of active and passive smoking on ventilatory function assessed by spirometry in 1,397 community-dwelling men and w omen aged 51-95 years and observed that active smoking affected ventil atory function into advanced old age. Smokers who quit before age 40 h ad an age- and height-adjusted forced expiratory volume in 1 second (F EV(1)) (in liters) that did not differ from that of never smokers in e ither men (3.06 (standard deviation (SD) = 0.58) vs. 3.06 (SD = 0.60), p = 0.99) or women (2.09 (SD = 0.51) vs. 2.13 (SD = 0.46), p = 0.51). In smokers who quit between ages 40 and 60, FEV(1) was lower than tha t of never smokers and higher than that of current smokers in both men and women. Male and female smokers who quit after age 60 had a FEV(1) similar to current smokers. FEV(1) correlated significantly with the duration since quitting smoking (r = 0.24, p = 0.0001 in men; and r = 0.26, p = 0.0001 in women) and with the duration of smoking (r = -0.30 , p = 0.0001 in both men and women). FEV(1) and forced midexpiratory r ate in 25-75 seconds were not lower in either male or female nonsmoker s passively exposed to cigarette smoke at home. These results confirm the deleterious effect of active smoking and demonstrate a beneficial effect of quitting smoking before age 40, with an apparent lack of ben efit on pulmonary function if cessation is delayed to age 60.