Table 2.8Longitudinal studies on the association between smoking and maximum attained level of forced expiratory volume in one second (FEV1), rates of growth, age of plateau in lung function, and age of onset of decline in lung function

StudyPopulationPeriod of study/follow-upLung function outcomeType of study/comments
Tager et al. 1985669 children
5–19 years of age at baseline
East Boston, Massachusetts
Baseline: 1974–1975
Follow-up: 8 annual examinations
Smoking led to decrease in rate of growth of FEV1 (p <0.001) and FEF25–75Longitudinal; 72.5% of original 411 families still under observation at conclusion of 8th annual examination
Tager et al. 1988913 males and 974 females with at least one measurement of FEV1
34% random sample of children
5–9 years of age and their families
East Boston, Massachusetts
Baseline: 1974–1975
Follow-up: 10 annual examinations
Maximal FEV1 level same for smokers and nonsmokers but reached earlier for smokers
Asymptomatic nonsmoking males demonstrated either a prolonged plateau phase or period of slow, continued FEV1 growth from 23 to 35 years of age, followed by slow decline of −20–30 mL/year
No plateau phase for smoking males; decline for smokers began earlier, in 1st part of 3rd decade at rate of 25–30 mL/year
Maximal FEV1 level lower (2.9 vs. 3.1 L) and reached 1 year earlier for smokers compared with nonsmokers
Female current smokers had more rapid rate of early decline than female nonsmokers
Longitudinal; approximately 70% of subjects still under observation at the 10th survey
Robbins et al. 1995All male: 111 nonsmokers; 110 smokers
Metal processing plant employees
United States
Baseline: 1975
Follow-up: quarterly for up to 10 years
Subjects selected if 5 or more observations at age 18–33 years with at least 1.5 years of follow-up
Only tests up to 33 years of age included
As many as 40% of adult males 33 years of age or younger had significant slopes: either growth or decline in lung function, rather than a plateau
A larger proportion of smokers had negative slopes (63%) than did nonsmokers (49%) (p = 0.2)
Longitudinal; working population of White men
Gold et al. 19965,158 boys
4,902 girls
Baseline: White children enrolled in the 1st–4th grades from 6 U.S. cities
Study used data from children 10–18 years of age
Baseline: 1974–1979
Follow-up: annually through grade 12
Inverse association between amount smoked and level of FEV1/FVC and FEF25–75 for boys and girls
Rate of lung growth lower for smokers by 9 mL/year (95% CI, −6–24 mL/year)
Rate of lung growth slower for smokers by 31 mL/year (95% CI, 16–46 mL/year)
Maximal attained FEF25–75 lower for smokers than for nonsmokers (3.65 L/second vs. 3.80 L/second)
At age 18, nonsmokers plateaued; smokers began early decline of FEV1
Longitudinal; girls reached the maximal level of lung function between the ages of 16 and 18 years, a period when level of lung function was still increasing in boys
Twisk et al. 199878 males
89 females
Mean age 13 years at baseline
Baseline: 1977
Follow-up: 6 follow-up measurements over 14 years, final measurement at age 27 years in 1991
Rate of growth of FVC and FEV1 slower for smokersLongitudinal; complete data for 14 years of follow-up available on 181 of 307 persons enrolled in 1977; 14 with asthma excluded from analyses
Doyle et al. 200360 consecutive extremely-low-birth-weight survivorsBaseline: 1977–1980
Follow-up at 20 years of age
Proportion with FEV1/FVC <75% significantly higher in smokers than in nonsmokers (64% vs. 20%)
Larger decrease in FEV1/FVC ratio between the ages of 8 and 20 years in smokers (mean change −8.2%; 95% CI, −14.1 to 2.4)
Longitudinal; follow-up at age 20 years in 44 of the survivors (73%)
Wang et al. 20041,818 males
1,732 females
15–35 years of age
The Netherlands
Vlagtwedde, 1965–1967
Vlaardingen, 1969
Follow-up: every 3 years for 24 years
Inverse association between amount smoked and level of FEV1/FVC and FEF25–75 for males and females
For males, current and cumulative smoking predicted reduced maximal level of FEV1 for males

Note: CI = confidence interval; FEF25–75 = forced expiratory flow between 25% and 75% of forced vital capacity; FVC = forced vital capacity; L = liter; mL = milliliter.

From: 2, The Health Consequences of Tobacco Use Among Young People

Cover of Preventing Tobacco Use Among Youth and Young Adults
Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General.
National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health.

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