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 and that this decline is accelerated by cigarette smoking, the effects of such factors are not well established in elderly individuals. The authors examined the effect of active and passive smoking on ventilatory function assessed by spirometry in 1,397 community-dwelling men and women aged 51-95 years and observed that active smoking affected ventilatory function into advanced old age. Smokers who quit before age 40 had an age- and height-adjusted forced expiratory volume in 1 second (FEV(1)) (in liters) that did not differ from that of never smokers in either 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 that 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 rate in 25-75 seconds were not lower in either male or female nonsmokers 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 benefit on pulmonary function if cessation is delayed to age 60.