Evaluation of Pulmonary Function Changes in Smokers versus Non-Smokers Using Spirometry

Smoking and Pulmonary Function

Authors

  • Raheela Adil Associate Professor, Department of Physiology, RYK Medical College, Rahim Yar Khan, Pakistan Author
  • Anam Rehman Assistant Professor, Department of Biochemistry, Queens Medical College, Kasur, Pakistan. Author
  • Waleed Arshad Assistant Professor, Department of Pharmacology, Queens Medical College, Kasur, Pakistan. Author

DOI:

https://doi.org/10.69750/dmls.02.08.0145

Keywords:

Pulmonary function, spirometry, smokers, non-smokers, FEV1, FVC

Abstract

Background: Cigarette smoking is a major preventable cause of morbidity and mortality worldwide, contributing significantly to chronic respiratory diseases. Pulmonary function testing using spirometry provides an objective means of assessing smoking-related airway impairment and detecting early subclinical changes.

Objective: This study aimed to evaluate pulmonary function changes among smokers compared to non-smokers using spirometry in a tertiary care setting in Punjab, Pakistan.

Methods: A Cross-sectional comparison study was conducted at two tertiary care facilities between March 2024 and March 2025. Using purposive sampling, 90 individuals between the ages of 20 and 60 were enrolled, 45 of them were smokers and the remaining 45 were non-smokers. Using a systematic questionnaire, demographic and clinical data, including smoking history, were collected. The American Thoracic Society (ATS) recommendations were followed while doing the spirometry, and the findings were assessed for peak expiratory flow rate (PEFR), forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. The Statistical Package for Social Sciences (SPSS) software version 26 was used to analyze the data. Pearson's correlation test was used to determine the relationship between smoking exposure and spirometric indices, and independent t tests were used for group comparisons.

Results: Smokers demonstrated significantly reduced mean FEV1 (2.29 ± 0.61 L vs. 3.01 ± 0.55 L, p < 0.001), lower FEV1/FVC ratios (68.5% ± 7.2 vs. 81.1% ± 6.5, p < 0.001), and decreased PEFR (314.6 ± 72.8 L/min vs. 386.2 ± 68.9 L/min, p < 0.001) compared to non-smokers. Obstructive patterns were observed in 42.2% of smokers versus 8.9% of non-smokers. Pack-year analysis showed a significant inverse correlation with both FEV1 (r = –0.41, p = 0.004) and FEV1/FVC ratio (r = –0.38, p = 0.006).

Conclusion: Smoking is strongly associated with impaired pulmonary function, particularly obstructive airway changes. Spirometry is a valuable tool for early detection, highlighting the need for routine screening and targeted smoking cessation interventions to prevent progressive lung disease.

Downloads

Download data is not yet available.

References

Oelsner EC, Balte PP, Bhatt SP, et al. Lung function decline in former smokers and low-intensity current smokers: a secondary data analysis of the NHLBI Pooled Cohorts Study. Lancet Respir Med. 2020;8(1):34-44. doi:10.1016/S2213-2600(19)30276-0

McKleroy W, Shing T, Anderson WH, et al. Longitudinal follow-up of participants with tobacco exposure and preserved spirometry. JAMA. 2023;330(5):442-453. doi:10.1001/jama.2023.11676

Han MK, Ye W, Wang D, et al; RETHINC Study Group. Bronchodilators in tobacco-exposed persons with symptoms and preserved lung function. N Engl J Med. 2022;387(13):1173-1184. doi:10.1056/NEJMoa2204752

Stanojevic S, Graham BL, Cooper BG, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests. Eur Respir J. 2022;60(1):2101499. doi:10.1183/13993003.01499-2021

Smith BM, Kirby M, Hoffman EA, et al. Association of dysanapsis with chronic obstructive pulmonary disease among older adults. JAMA. 2020;323(22):2268-2280. doi:10.1001/jama.2020.6918

Wan ES, Balte P, Schwartz JE, et al. Association between preserved ratio impaired spirometry and clinical outcomes in US adults. JAMA. 2021;326(24):2487-2498. doi:10.1001/jama.2021.20766

Tian T, Jiang X, Qin R, et al. Effect of smoking on lung function decline in Chinese males: cross-sectional and longitudinal analyses. Front Med (Lausanne). 2023;10:843162. doi:10.3389/fmed.2022.843162

Fortis S, Comellas AP, Jacobs DR Jr, et al. Respiratory exacerbations in people with cigarette smoking but normal spirometry and subsequent lung function decline. Am J Respir Crit Care Med. 2025;211(6):e1-e12. doi:10.1164/rccm.202401-0023OC

Rodríguez-Álvarez MM, Sobrino-Leal A, Rodrigo-Matos A, et al. Spirometry-guided counseling and smoking cessation in primary care: randomized trial. Int J Environ Res Public Health. 2022;19(21):14557. doi:10.3390/ijerph192114557

Darabseh MZ, Al-Khatib S, Khassawneh B, et al. Impact of vaping and smoking on maximum respiratory pressures and spirometry. Int J Adolesc Med Health. 2021;33(6):461-468. doi:10.1515/ijamh-2021-0056

Balte PP, Chaves PHM, Couper DJ, et al. Nonobstructive chronic bronchitis and respiratory health outcomes in adults. JAMA Intern Med. 2020;180(5):676-686. doi:10.1001/jamainternmed.2020.0104

Çolak Y, Afzal S, Nordestgaard BG, Lange P. Characteristics and prognosis of never-smokers and smokers with airflow limitation in the general population. Respir Med. 2021;182:106402. doi:10.1016/j.rmed.2021.106402

Çolak Y, Afzal S, Nordestgaard BG, Lange P. Prognosis of symptomatic smokers with preserved spirometry. Eur Respir J. 2020;55(1):1901311. doi:10.1183/13993003.01311-2019

Çolak Y, Afzal S, Nordestgaard BG, Lange P. Association of smoking intensity with FEV1 decline and COPD risk in the general population. Thorax. 2022;77(11):1052-1060. doi:10.1136/thoraxjnl-2021-218174

Çolak Y, Afzal S, Nordestgaard BG, Lange P. Smoking cessation, weight change, and lung function decline. JAMA Netw Open. 2020;3(11):e2027344. doi:10.1001/jamanetworkopen.2020.27344

Wang Z, Yang L, Qin L, et al. Low FEV1 in young adults and subsequent morbidity and mortality: a population-based cohort. Respir Res. 2024;25(1):103. doi:10.1186/s12931-024-02777-6

Mehta P, Hall GL, Stanojevic S, et al. Global Lung Function Initiative (GLI) reference values update for spirometry in adolescents and adults: multi-ethnic data harmonization. Eur Respir J. 2022;60(5):2201693. doi:10.1183/13993003.01693-2022

Washio Y, Sato S, Tanaka J, et al. Small airway dysfunction assessed by spirometry indices and smoking exposure in adults without COPD. Respir Investig. 2021;59(6):760-768. doi:10.1016/j.resinv.2021.08.006

Mahler DA, Criner GJ, Dransfield MT, et al. Peak inspiratory flow rate, smoking history, and airflow limitation: implications for inhaler therapy. Chest. 2021;160(5):1735-1746. doi:10.1016/j.chest.2021.05.063

Çolak Y, Afzal S, Nordestgaard BG, Lange P. Preserved ratio impaired spirometry, respiratory symptoms, and all-cause mortality. Eur Respir J. 2021;57(1):2000045. doi:10.1183/13993003.00045-2020

Porteous MK, Lee HJ, Han MK, et al. Quantitative CT metrics and symptoms in smokers with preserved spirometry. Chest. 2020;158(2):792-803. doi:10.1016/j.chest.2020.01.058

Doiron D, de Hoogh K, Probst-Hensch N, et al. Air pollution, smoking and lung function in cohorts across Europe: the ALEC study. Int J Epidemiol. 2020;49(1):149-161. doi:10.1093/ije/dyz063

Downloads

Crossmark - Check for Updates PlumX Metrics

Published

26-09-2025

How to Cite

Adil, R. ., Rehman, A. ., & Arshad, W. . (2025). Evaluation of Pulmonary Function Changes in Smokers versus Non-Smokers Using Spirometry: Smoking and Pulmonary Function. DEVELOPMENTAL MEDICO-LIFE-SCIENCES, 2(8), 24-31. https://doi.org/10.69750/dmls.02.08.0145

Share