Tabaksgebruik
Tabaksgebruik beïnvloedt spirometrische gegevens op verschillende manieren:
- Het maximale niveau in VC en FEV1 dat tijdens de groei wordt bereikt (ref. 1). Dit wordt nadelig beïnvloed door directe of indirecte blootstelling aan tabaksrook vanaf conceptie tot het eind van de adolescentie. Rokende adolescenten bereiken naar schatting een 360-390 mL lager FEV1 dan niet-rokers.
- De zgn. plateaufase, d.w.z. de overgangszone tussen groei in longfunctie en verouderingsverschijnselen, wordt bekort (ref. 2).
- Versnelde achteruitgang in longfunctie bij volwassenen (ref. 3). Deze achteruitgang is sterker naarmate meer wordt gerookt (sigaretten, sigaren en pijp) en het roken langer wordt volgehouden (ref. 4). De gevoeligheid voor de ongunstige effecten op het FEV1 is individueel bepaald: een minderheid van de rokers ontwikkelt een versnelde daling van het FEV1.
(animatie tijdelijk met Engelse tekst)
Stoppen met roken gaat gepaard met een kleine verbetering van het FEV1, terwijl de jaarlijkse teruggang in FEV1 vergelijkbaar wordt met die in niet-rokers (ref. 4) .
| Ref. 1 - Blootstelling aan tabaksrook op kinderleeftijd | |
| 1 | Tager IB, Weiss ST, Munoz A, Rosner B, Speizer FE. Longitudinal study of the effects of maternal smoking on pulmonary function in children. N Engl J Med 1983; 309: 699-703. |
| 2 | Tager IB, Munoz A, Rosner B, Weiss S, Varey V. Effect of cigarette smoking on the pulmonary function of children and adolescents. Am Rev Respir Dis 1985; 131: 752-759. |
| 3 | Lebowitz MD, Holberg CJ, Knudson RJ, Burrows B. Longitudinal study of pulmonary function development in childhood, adolescence and early adulthood. Development of pulmonary function. Am Rev Respir Dis 1987; 136: 69-75. |
| 4 | Tager IB, Segal MR, Speizer FE, Weiss ST. The natural history of forced expiratory volumes,. Effects of smoking and respiratory symptoms. Am Rev Respir Dis 1988; 138: 837-849. |
| 5 | Young S, LeSouëf PN, Geelhoed GC, Stick SM, Turner KJ, Landau LI. The influence of a family history of asthma and parental smoking on airway responsiveness in early infancy. N Engl J Med 1991; 324: 1168-1173. |
| 6 | Tager IB, Ngo I, Hanrahan JP. Maternal smoking during pregnancy: effects on lung function during the first 18 months of life. Am J Respir Crit Care Med 1995; 152: 977-983. |
| 7 | Samet JM, Lange P. Longitudinal studies of active and passive smoking. Am J Respir Crit Care Med 1996; 154: S257-S265. |
| 8 | Wang X, Wypij D, Gold DR, Speizer FE, Ware JH, Ferris BG Jr, et al. Effects of smoking on lung function in adolescent boys and girls. N Engl J Med 1996; 335: 931-937. |
| 9 | Gold DR, Wang X, Wypij D, Speizer FE, Ware JH, Dockery DW. Effects of cigarette smoking on lung function in adolescent boys and girls. N Engl J Med 1996; 335: 931-937. |
| Ref. 2 - Roken en plateaufase longfunctie | |
| 1 | Tager IB, Segal MR, Speizer FE, Weiss ST. The natural history of forced expiratory volumes. Effects of smoking and respiratory symptoms. Am Rev Respir Dis 1988; 138: 837-849. |
| 2 | Tager IB, Munoz A, Rosner B, Weiss S, Varey V. Effect of cigarette smoking on the pulmonary function of children and adolescents. Am Rev Respir Dis 1985; 131: 752-759. |
| 3 | Lebowitz MD, Holberg CJ, Knudson RJ, Burrows B. Longitudinal study of pulmonary function development in childhood, adolescence and early adulthood. Development of pulmonary function. Am Rev Respir Dis 1987; 136: 69-75. |
| Ref. 3 - Roken en versnelde achteruitgang longfunctie | |
| 1 | Comstock GW, Brownlow WJ, Stone RW, Sartwell PE. Cigarette smoking and changes in respiratory findings. Arch Environ Health 1970; 21: 50-57. |
| 2 | Sharp JT, Paul O, McKean H, Best WR. A longitudinal study of bronchitic symptoms and spirometry in a middle-aged male industrial population. Am Rev Respir Dis 1973; 108: 1066-1077. |
| 3 | Fletcher CM, Peto R, Tinker CM, Speizer FE. The natural history of chronic bronchitis and emphysema. An eight-year study of early chronic obstructive lung disease in working men in London. Oxford, Oxford University Press 1976. |
| 4 | Fletcher CM, Peto R. The natural history of chronic airflow obstruction. BMJ 1977; 1: 1645-1648. |
| 5 | Kauffmann F, Querleux E, Drouet D, Lellouch J, Brille D. Twelve year FEV1 changes and smoking habits among 556 workers in the Paris area. Bull Eur Physiopathol Resp 1979; 15: 723-737. |
| 6 | Bosse R, Sparrow D, Garvey AJ, Costa PT, Weiss ST, Rowe JW. Cigarette smoking, aging, and decline in pulmonary function: a longitudinal study. Arch Environ Health 1980; 35: 247-252. |
| 7 | Van der Lende R, Kok TJ, Peset Reig R, Quanjer PhH, Schouten JP, Orie NGM. Decreases in VC and FEV1 with time: indicators for effects of smoking and air pollution. Bull Eur Physiopathol Respir 1981; 17: 775-792. |
| 8 | Clément J, van de Woestijne KP. Rapidly decreasing forced expiratory volume in one second or vital capacity and development of chronic airflow limitation. Am Rev Respir Dis 1982; 125: 553-558. |
| 9 | Camilli AE, Burrows B, Knudson RJ, Lyle SK, Lebowitz MD. Longitudinal changes in forced expiratory volume in one second in adults. (Effects of smoking and smoking cessation). Am Rev Respir Dis 1987; 135: 794-799. |
| 10 | Tager IB, Segal MR, Speizer FE, Weiss ST. The natural history of forced expiratory volumes. Effects of smoking and respiratory symptoms. Am Rev Respir Dis 1988; 138: 837-849. |
| 11 | Xu X, Weiss ST, Rijcken B, Schouten JP. Smoking, changes in smoking habits, and rate of decline in FEV1: new insights into gender differences. Eur Respir J 1994; 7: 1056-1061. |
| Ref. 4 - Stoppen met roken en longfunctie | |
| 1 | Bosse R, Sparrow D, Rose CL, Weiss ST. Longitudinal effect of age and smoking cessation on pulmonary function. Am Rev Respir Dis 1981; 123: 378-381. |
| 2 | Tashkin DP, Clark VA, Coulson AH, Simmons M, Bourque LB, Reems C, et al. The UCLA population studies of chronic obstructive respiratory disease. VIII. Effects of smoking cessation on lung function: a prospective study of a free-living population,. Am Rev Respir Dis 1984; 130: 707-715. |
| 3 | Camilli AE, Burrows B, Knudson RJ, Lyle SK, Lebowitz MD. Longitudinal changes in forced expiratory volume in one second in adults. (Effects of smoking and smoking cessation). Am Rev Respir Dis 1987; 135: 794-799. |
| 4 | Xu X, Weiss ST, Rijcken B, Schouten JP. Smoking, changes in smoking habits, and rate of decline in FEV1: new insights into gender differences. Eur Respir J 1994; 7: 1056-1061. |
| 5 | Anthonisen NR, Connett JE, Kiley JP, Altose MD, Bailey WC, Buist AS, et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1: the Lung Health Study. JAMA 1994; 272: 1497-1505. |
| 6 | Burchfiel CM, Marcus EB, Curb JD, MacLean CJ, Vollmer WM, Johnson IR, et al. Effects of smoking and smoking cessation on longitudinal decline in pulmonary function. Am J Respir Crit Care Med 1995; 151: 1778-1785. |