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Multiple attempts to stop smoking, even with relapses, reduced loss of pulmonary function

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Question What are the effects of multiple failed attempts to stop smoking on pulmonary function of adults?


Retrospective analysis of a cohort of participants involved in a randomised controlled trial (Lung Health Study), with annual follow up for 5 years.


10 clinical centres in North America.*


5887 adults aged 35–60 years, who smoked and had evidence of early chronic obstructive pulmonary disease (ie, had an FEV1/FVC [forced expiratory volume at 1 sec/forced vital capacity] interval of ≤70%, and an FEV1 of 55–90% of predicted normal).

Assessment of risk factors

Smoking status was assessed at baseline and at 5 annual visits thereafter. Participant reports of abstinence were confirmed by salivary cotinine concentrations (<20 ng/ml) or if nicotine substitution therapy was used, by CO concentrations (<10 ppm in end tidal …

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  • Sources of funding: Division of Lung Diseases of the National Heart, Lung, and Blood Institute; Boehringer Ingelheim Pharmaceutical, Marion Merrell Dow, and Merrell Dow Pharmaceuticals (Canada) contributed drugs used by the study.

  • For correspondence: Dr R P Murray, Section of Clinical Epidemiology and Outcome Evaluation, Room MS754, Health Sciences Centre, University of Manitoba, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada. Fax +1 204 789 3905.

  • * Anthonisen NR, Connett JE, Kiley JP, et al for the Lung Health Study Research Group. JAMA 1994;272:1497–505.