Functional abnormalities in young asymptomatic smokers with special reference to flow volume curves breathing various gases.

Functional abnormalities have been described in healthy, asymptomatic young smokers. Fifteen subjects between 22 and 30 years of age, who smoked but were completely asymptomatic, were compared with 10 nonsmokers of the same age group using lung volumes, maximal expiratory flow rates, closing volumes, and maximal expiratory flow volume curves breathing air and a helium-oxygen mixture. Lower maximal mid-expiratory flow rates, higher closing volumes, and significant differences in flow volume curves with the helium-oxygen mixture were found in smokers. Special attention was given to the volume expressed as percentage of vital capacity at which the flows with air and the helium-oxygen mixture were equal for each subject ("equal-flow volume"). This volume was found to be significantly higher for smokers than nonsmokers. The authors offer explanations for these differences and suggest that smoking may alter compliance, as reflected by abnormal closing volumes, and resistance of the small airways as determined by differing responses in flow rates after helium-oxygen breathing at low volumes.