Airway changes in young smokers that may antedate chronic obstructive lung disease

Careful analysis among smoking subjects has shown striking heterogeneity of the group: some display evidence of a brisk airway response while others seemingly are less affected. Our intention is to review some of these changes that seem to relate to parameters of lung host defenses, for this offers an unique opportunity to document effects related to cigarette smoming early in the life of a smoker, well before changes in pulmonary function can be noted and decades before overt disease may occur. Thus, the precursors of disease may be evident early on or special risks identified that could be the basis for strong behavior modification of smoking habits or exposure, if the airway changes presently identified are the ones that ultimately correlate with disease related to smoking. We will then attempt to interrelate these subtle abnormalities of host defense with problems that subsequently develop in patients with one overt cigarette associated lung illness, chronic obstructive airways disease.