Pipe and Cigar Smoking and Lung Function. Ann Intern Med. 2010;152:I-28. doi: 10.7326/0003-4819-152-4-201002160-00001
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Published: Ann Intern Med. 2010;152(4):I-28.
Chronic obstructive pulmonary disease (COPD) is a disease of the lungs and the tubes that bring air to the lungs. It is the fourth leading cause of death and will soon replace stroke as the third leading cause of death. People with COPD cough and get short of breath. Damage to the lungs and symptoms of COPD slowly worsen over time. Doctors treat COPD with drugs that widen and decrease swelling in the airways. Oxygen therapy can help some people with COPD. Pulmonary rehabilitation, which involves patient education and exercise, is another type of COPD treatment. It is well known that cigarette smoking is the major cause of the disease. Few studies have examined whether pipe and cigar smoking are also associated with changes in lung function that result in COPD. Because rates of pipe and cigar smoking are increasing in some places, including the United States, it is important to understand whether smoking these tobacco products damages lung function.
To determine whether changes in lung function are associated with pipe and cigar smoking.
3528 people aged 48 to 90 years who were participating in a study of risk factors for cardiovascular disease.
People who participated in the study completed detailed questionnaires about their past and current smoking behaviors. They also completed spirometry. Spirometry is a breathing test that can diagnose COPD on the basis of a measurement called FEV1 (forced expiratory volume in 1 second), which is the amount of air that a person exhales in 1 second compared with that of a healthy person of the same age and size. A person with an FEV1 of 60% exhales about 60% the amount that a typical, healthy person of the same age and size exhales in 1 second. Researchers looked at the associations of pipe, cigar, and cigarette smoking with changes in lung function that were found on spirometry.
Of the 3528 people in the study, 9 out of every 100 reported ever smoking a pipe, 11 out of every 100 reported ever smoking cigars, and more than half reported ever smoking cigarettes. Greater use of pipes, cigars, and cigarettes were each associated with worsening measures of lung function. Of note, even if they did not also smoke cigarettes, people who smoked pipes or cigars had about twice the risk for abnormal lung function than never smokers.
This study asked people to report on previous smoking behaviors, and reports may not be completely accurate; however, reports of current smoking were checked by measuring for products of tobacco smoke in the urine. Information on whether participants who had abnormal lung test results also had symptoms of lung disease was not analyzed.
Pipe and cigar smoking is associated with obstructive lung disease, which is one of the reasons to avoid these tobacco products. Other bad health effects of pipe and cigar smoking include heart disease, lung cancer, and cancer of the mouth and throat.
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Cardiology, Tobacco, Alcohol, and Other Substance Abuse, Coronary Risk Factors, Smoking.
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