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Effects of Rapid Smoking: Physiologic Evaluation of a Smoking-Cessation Therapy

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Grant support: by the Medical Research Service of the Veterans Administration and NIDA Program Project No. DA4RG012. Dr. Sachs was a Fellow of the San Francisco Lung Association while conducting this study.

Presented in part at the 58th Annual Session of the American College of Physicians, April 1977, Dallas, Texas.

▸Requests for reprints should be addressed to David P.L. Sachs, M.D.; Department of Medicine, University Hospitals of Cleveland; 2065 Adelbert Road; Cleveland, OH 44106.

Palo Alto, California

©1978 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1978;88(5):639-641. doi:10.7326/0003-4819-88-5-639
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We studied 24 healthy young male smokers to ascertain the medical safety of a highly effective smoking-abatement technique called rapid smoking. In comparison with results obtained after a 12-h cigarette fast or after normal smoking, statistically significant increases occurred after rapid smoking in heart and respiratory rates, systolic blood pressure, carboxyhemoglobin, and pH (p < 0.05), while arterial PCO2, HCO3, and serum [K+] fell (p < 0.05). Rapid smoking produced alveolar hyperventilation in all subjects. In eight, arterial PO2 increased appropriately, but in 16, fell paradoxically (p < 0.01); seven had arterial PO2 below 80 torr. Because this fall could represent ventilation/perfusion mismatch due to early bronchoconstrictive disease, in subjects with normal flow/volume loops and spirometry rapid smoking may be a simple, provocative screening test for early airway disease. Despite the changes produced there were no arrhythmias. Rapid smoking is safe for healthy subjects but should not now be used for higher-risk patients.





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