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November 16, 1994, Vol 272, No. 19 >
ARTICLE | November 16, 1994

The Lung Health Study: Title and subTitle BreakDisappointment and Triumph FREE

Nicholas J. Gross, MD, PhD
[+] Author Affiliations

Reprint requests to PO Box 1430, Hines, IL 60141 (Dr Gross).

Reprint requests to National Highway Traffic Safety Administration, 400 Seventh St SW, Room 5220, Washington, DC 20590 (Dr Martinez).


JAMA. 1994;272(19):1539-1541. doi:10.1001/jama.1994.03520190085040
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References

Chronic obstructive pulmonary disease (COPD) is a major and growing health problem throughout the world. In the United States, close to 13 million people were recognized to have the condition in 1986,1 but even this staggering number is probably an underestimate.2 Its annual cost was more than $12 billion in direct and indirect medical expenses in 1990. It is now the fourth leading cause of death in this country, with a mortality of more than 90 000 in 1991.3 These figures do not reveal an equally vital statistic, the great physical limitation and suffering of many of these patients in the last years of their lives. The principal etiologic factor, and by far the most potent one, cigarette smoking, has been known for decades. Moreover, the classic studies of Fletcher et al in the United Kingdom4 and the studies of many others

See also p 1497.

REFERENCES

1 +
National Center for Health Statistics.  Current estimates from the National Health Interview Survey: United States, 1986. Vital Health Stat 10 . 1987;;No. (164) .
2 +
Redline S.  The epidemiology of COPD.  In: Cherniack NS, ed. Chronic Obstructive Pulmonary Disease . Philadelphia, Pa: WB Saunders Co; 1991;:225-234.
3 +
National Center for Health Statistics.  Advance report of final mortality statistics, 1991. Monthly Vital Stat Rep . 1993;;42( (suppl 2) ):1-61.
4 +
Fletcher C, Peto R, Tucker C, Speizer FE. The Natural History of Chronic Bronchitis and Emphysema . New York, NY: Oxford University Press; 1976;.
5 +
Hughes JA, Hutchison DC, Bellamy D, Dowd DE, Ryan KC, Hugh-Jones P.  The influence of cigarette smoking and its withdrawal on the annual change of lung function in pulmonary emphysema. Q J Med . 1982;;51:115-124.
6 +
Kanner RE, Renzetti AD Jr, Klauber MR, Smith CB, Golden CA.  Variables associated with changes in spirometry in patients with obstructive lung disease. Am J Med . 1979;;67:44-50.
7 +
Hypertension Detection and Follow-up Program Cooperative Group.  Five-year findings of the hypertension detection and follow-up program, I: reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA . 1979;;242:2562-2571.
8 +
Multiple Risk Factor Intervention Trial Research Group.  Multiple Risk Factor Intervention Trial: risk factor changes and mortality results. JAMA . 1982;;248:1465-1477.
9 +
Lipid Research Clinics Program.  The Lipid Research Clinics Coronary Primary Prevention Trial results, I: reduction in incidence of coronary heart disease. JAMA . 1984;;251:351-364.
10 +
Anthonisen NR, Connett JE, Kiley JP, 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.
11 +
Buist AS, Connett JE, Miller RD, Kanner RE, Owens GR, Voelker HT.  Chronic Obstructive Pulmonary Disease Early Intervention Trial (Lung Health Study): baseline characteristics of randomized participants. Chest . 1993;;103:1863-1872.
12 +
Barter CE, Campbell AH.  Relationship of constitutional factors and cigarette smoking to decrease in 1-second forced expiratory volume. Am Rev Respir Dis . 1976;;113:305-314.
13 +
Anthonisen NR, Wright EC, IPPB Trial Group.  Bronchodilator response in chronic obstructive pulmonary disease. Am Rev Respir Dis . 1986;;133:814-819.
14 +
Gross NJ, Skorodin MS.  Role of the parasympathetic system in airway obstruction due to emphysema. N Engl J Med . 1984;;311:421-426.
15 +
Tashkin DP, Ashutosh K, Bleecker ER, et al.  Comparison of the anticholinergic bronchodilator ipratropium bromide with metaproterenol in chronic obstructive pulmonary disease: a 90-day multi-center study. Am J Med . 1986;;81( (suppl 5A) ):81-90.
16 +
Anthonisen NR.  Lung Health Study. Am Rev Respir Dis . 1989;;140:871-872.
17 +
 The Lung Health Study: design of the trial and recruitment of participants. Control Clin Trials . 1993;;14( (suppl) ):1S-84S.
18 +
Tashkin DP, Altose MD, Bleecker ER, et al.  The Lung Health Study: airway responsiveness to inhaled methacholine in smokers with mild to moderate airflow limitation. Am Rev Respir Dis . 1992;;145:301-310.

Figures

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Interactive Graphics

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
National Center for Health Statistics.  Current estimates from the National Health Interview Survey: United States, 1986. Vital Health Stat 10 . 1987;;No. (164) .
2 +
Redline S.  The epidemiology of COPD.  In: Cherniack NS, ed. Chronic Obstructive Pulmonary Disease . Philadelphia, Pa: WB Saunders Co; 1991;:225-234.
3 +
National Center for Health Statistics.  Advance report of final mortality statistics, 1991. Monthly Vital Stat Rep . 1993;;42( (suppl 2) ):1-61.
4 +
Fletcher C, Peto R, Tucker C, Speizer FE. The Natural History of Chronic Bronchitis and Emphysema . New York, NY: Oxford University Press; 1976;.
5 +
Hughes JA, Hutchison DC, Bellamy D, Dowd DE, Ryan KC, Hugh-Jones P.  The influence of cigarette smoking and its withdrawal on the annual change of lung function in pulmonary emphysema. Q J Med . 1982;;51:115-124.
6 +
Kanner RE, Renzetti AD Jr, Klauber MR, Smith CB, Golden CA.  Variables associated with changes in spirometry in patients with obstructive lung disease. Am J Med . 1979;;67:44-50.
7 +
Hypertension Detection and Follow-up Program Cooperative Group.  Five-year findings of the hypertension detection and follow-up program, I: reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA . 1979;;242:2562-2571.
8 +
Multiple Risk Factor Intervention Trial Research Group.  Multiple Risk Factor Intervention Trial: risk factor changes and mortality results. JAMA . 1982;;248:1465-1477.
9 +
Lipid Research Clinics Program.  The Lipid Research Clinics Coronary Primary Prevention Trial results, I: reduction in incidence of coronary heart disease. JAMA . 1984;;251:351-364.
10 +
Anthonisen NR, Connett JE, Kiley JP, 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.
11 +
Buist AS, Connett JE, Miller RD, Kanner RE, Owens GR, Voelker HT.  Chronic Obstructive Pulmonary Disease Early Intervention Trial (Lung Health Study): baseline characteristics of randomized participants. Chest . 1993;;103:1863-1872.
12 +
Barter CE, Campbell AH.  Relationship of constitutional factors and cigarette smoking to decrease in 1-second forced expiratory volume. Am Rev Respir Dis . 1976;;113:305-314.
13 +
Anthonisen NR, Wright EC, IPPB Trial Group.  Bronchodilator response in chronic obstructive pulmonary disease. Am Rev Respir Dis . 1986;;133:814-819.
14 +
Gross NJ, Skorodin MS.  Role of the parasympathetic system in airway obstruction due to emphysema. N Engl J Med . 1984;;311:421-426.
15 +
Tashkin DP, Ashutosh K, Bleecker ER, et al.  Comparison of the anticholinergic bronchodilator ipratropium bromide with metaproterenol in chronic obstructive pulmonary disease: a 90-day multi-center study. Am J Med . 1986;;81( (suppl 5A) ):81-90.
16 +
Anthonisen NR.  Lung Health Study. Am Rev Respir Dis . 1989;;140:871-872.
17 +
 The Lung Health Study: design of the trial and recruitment of participants. Control Clin Trials . 1993;;14( (suppl) ):1S-84S.
18 +
Tashkin DP, Altose MD, Bleecker ER, et al.  The Lung Health Study: airway responsiveness to inhaled methacholine in smokers with mild to moderate airflow limitation. Am Rev Respir Dis . 1992;;145:301-310.

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