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Question What are the effects of multiple failed attempts to stop smoking on pulmonary function of adults?
Design
Retrospective analysis of a cohort of participants involved in a randomised controlled trial (Lung Health Study), with annual follow up for 5 years.
Setting
10 clinical centres in North America.*
Participants
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 …