Patients with emphysema who continue to smoke have significant progression of lung damage, evident by decline in adjusted lung density on CT scan, within a decade of being diagnosed, according to a recent study published in the May 2023 issue of the journal Radiology.^1,2 Current smokers fared worse than former smokers.

David Baraghoshi from the Division of Pulmonary and Critical Care Medicine, Dept. of Medicine, National Jewish Health, Denver, Colorado and coauthors recruited 8431 current and former cigarette smokers with and without COPD between 2008 and 2020 from the COPDGene study with follow-ups at 5 years and 10 years. The selected subjects had a mean age of 60 years. Data of 4913 was available at 5-year follow-up, while 1544 participants were examined at 10-year follow-up. Through this study, they aimed to examine the progression of emphysema in participants with COPD using changes in adjusted lung density (ALD) obtained from quantitative CT.

Forty-nine percent of the study subjects were current smokers and 53% were found to have more than trace emphysema on CT scan at the start of the study. The greatest annual decrease in ALD was observed among participants who were current smokers and had more than trace emphysema. The mean annual decrease in the first 5 years was 1.4 g/L and it was 0.9 g/L in the next 5 years. The average decline was lowest among former smokers compared to that in the current smokers.

This study shows an association between smoking status and stage of emphysema with progression of emphysema. The disease progression within 10 years was greatest among those who had emphysema at the baseline and continued to smoke. These findings reiterate the benefits of smoking cessation even in patients with emphysema.

References

1. Baraghoshi D, et al. Quantitative CT evaluation of emphysema progression over 10 years in the COPDGene Study. Radiology. 2023 May;307(4):e222786. doi: 10.1148/radiol.222786.
2. https://www.nationaljewish.org/about/news/press-releases/2023-news/copdgene-study-follows-emphysema-patients-over-10-years. MAY 16, 2023. Accessed on May 27, 2023.