ArticlePloS one2021
Effects of cigarette smoke exposure on pulmonary physiology, muscle strength and exercise capacity in a retrospective cohort with 30,000 subjects.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 27 citations in OpenAlex.
- Effect of Smokeless Tobacco Consumption on Handgrip Strength and Surface Electromyographic Parameters in Obese Adult Males.Annals of neurosciences · 2026Article
- Predictors of Exercise Performance in Type 1 Diabetes: The Role of Hypoglycaemia Fear, Glycaemic Control, and Vascular Health: A Retrospective Cross-Sectional Study.Diabetes, obesity & metabolism · 2026Article
- Pulmonary Vascular Remodeling in Smokers: A Systematic Review of Quantitative CT and Histologic Evidence.Cureus · 2026Review
- The Influence of Smoking on Respiratory Function in Medical Students at the University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș.Biomedicines · 2026Article
- Emphysema Detection in Smokers: Diffusing Capacity for Nitric Oxide Beats Diffusing Capacity of Carbon Monoxide-Based Models.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025Article
- Assessment of smoking exposure by urine cotinine levels in severe COVID-19 patients: a case-control study.Scientific reports · 2025Observational
- Assessing the Effects of Bakhour on Pulmonary Functions in Young Adults in Saudi Arabia.Cureus · 2025Article
- Assessing the Impact of Air Quality and Socioeconomic Conditions on Respiratory Disease Incidence.Tropical medicine and infectious disease · 2025Article
- Respiratory rate and its associations with disease and lifestyle factors in the general population - results from the KORA-FF4 study.PloS one · 2025Article
- Article
- E.Co.Tech Breathalyzer: A Pilot Study of a Non-invasive COVID-19 Diagnostic Tool for Light and Non-smokers.ACS measurement science au · 2024Article
- Effectiveness of immunoglobulin replacement therapy in preventing infections in patients with chronic obstructive pulmonary disease: a systematic review.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2024Article
- The Mechanism of Effort Intolerance in Patients with Peripheral Arterial Disease: A Combined Stress Echocardiography and Cardiopulmonary Exercise Test.Journal of clinical medicine · 2023Article
- The Effect of Cadmium on Sleep Parameters Assessed in Polysomnographic Studies: A Case-Control Study.Journal of clinical medicine · 2023Article
- Inhaled COEnvironmental health insights · 2022Article
- Anesthetic considerations in smokers: A scoping review.Saudi journal of anaesthesiaReview
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effects of long-term cigarette smoke exposure on pulmonary physiology and how those effects lead to reduced exercise capacity are not well established.
methodsWe retrospectively analyzed the spirometry, single-breath gas transfer (DLCO), peripheral muscle strength, and maximum exercise capacity data in patients referred to McMaster University Medical Centre for cardiopulmonary exercise testing between 2000 and 2012.
results29,441 subjects underwent CPET and had a recorded smoking history [58% male, mean age 51.1 years (S.D.±19.6), BMI 27.4 kg/m2(±5.8)]. 7081 (24%) were current or former smokers and were divided into 4 categories by packs years (mean ±S.D.): <10 (5.8±3.3), 10-20 (17.1±2.9), 20-30 (27.1±2.8), 30-40 (37.3±2.8), and >40 (53.9±12.8). Patients with greater cigarette smoke exposure had lower expiratory flow rates (FEV1, FEF50, FEF75, PEFR), DLCO, and maximum power output (MPO) during exercise. There was no association between smoke exposure and muscle strength. Modeling MPO (kpm/min) output as a function of demographic and physiologic variables showed that the data are well explained by muscle strength (kg), FEV1 (L), and DLCO (mmHg/min/mL) in similar magnitude (MPO = 42.7*Quads0.34*FEV10.34 * DLCO0.43; r = 0.84).
conclusionsLong-term cigarette smoke exposure is associated with small airway narrowing and impaired diffusion capacity but not with peripheral muscle weakness. The effects of smoking, age, and gender on maximum power output are mediated by reductions in FEV1, muscle strength and DLCO. Exercise capacity in smokers may benefit from therapies targeting all 3 variables.
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