Relation of Smoking and Age to Findings in Lung Parenchyma: A Microscopic Study

Our plain-English summary of Relation of Smoking and Age to Findings in Lung Parenchyma: A Microscopic Study, by O. Auerbach, L. Garfinkel, E.C. Hammond (1974).

The study

• Authors: O. Auerbach, L. Garfinkel, E.C. Hammond
• Published: Chest, Volume 65 No1. January 1974
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This autopsy study examined lung tissue under the microscope to relate smoking and age to lung changes. The subjects were 1,824 men and women (388 women) autopsied at the Veterans Administration Hospital in East Orange, New Jersey, and six other hospitals. Relatives supplied smoking histories. One author read 16,536 slides in random order without knowing whose they were. In men, with average scores adjusted to the age mix of the whole study, emphysema scored 0.09 in those who never smoked regularly, 1.43 in current smokers of under half a pack of cigarettes a day, and 2.27 in current smokers of two or more packs. Age-adjusted fibrosis was about seven times as high in the under-half-pack group as in never-smokers. Thickening of small arteries and arterioles followed similar patterns. In men, these changes generally increased with age within smoking groups, with one exception noted for emphysema. Pipe and cigar smokers fell between never-smokers and cigarette smokers. Men who had quit cigarettes ten or more years earlier scored lower than recent quitters. The authors found essentially the same patterns in women.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Autopsy-based microscopic (pathology) study of lung tissue sections, read blind and in random order by one pathologist
• Who was studied: 1,824 men and women (388 women) whose lungs were obtained at autopsy at the VA Hospital, East Orange, N.J., and six other hospitals in New Jersey and upstate New York; the same subjects as the authors' earlier whole-lung section study
• Exposure: Tobacco smoking as reported by relatives: never smoked regularly; current cigarette smokers grouped by packs per day; pipe or cigar smokers who never smoked cigarettes regularly; former cigarette smokers. Age was also studied.
• Main results:
  • Men: average degree of emphysema, standardized to the age distribution of the total study population, was 0.09 in men who never smoked regularly, 1.43 in current smokers of less than one-half pack a day, and 2.27 in current smokers of 2 or more packs a day
  • Men: the age-standardized average degree of fibrosis was about seven times as high in current smokers of less than one-half pack a day as in never-smokers, and considerably higher in 2+ pack a day smokers
  • Men: emphysema was higher in cigarette smokers than in pipe or cigar smokers, and much higher than in never-smokers, in each age group
  • Men: within each smoking category emphysema was least under age 60, higher at 60-69, and (with one exception) highest at 70 and older
  • Men: within each smoking category, the mean degree of fibrosis, thickening of small arteries and thickening of arterioles increased with age (detailed age tables were not shown)
  • Men: padlike attachments to the alveolar walls were found in every current cigarette smoker and all but one pipe and cigar smoker, but in only 46 percent of never-smokers
  • Male former cigarette smokers, age-standardized emphysema: 0.24 (stopped 10+ years, under 1 pack a day, 35 men); 0.70 (stopped 10+ years, 1+ pack, 60); 1.08 (stopped under 10 years, under 1 pack, 51); 1.60 (stopped under 10 years, 1+ pack, 131)
  • Women, age-standardized emphysema: 0.05 in never-smokers, 1.37 in those smoking under 1 pack a day, and 1.70 in those smoking 1+ pack a day. Of the 388 women, 252 never smoked.
• The authors' conclusion: The authors concluded that, despite differences in technique and in the dates of death, findings among men were essentially the same as in their earlier microscopic study. Lung changes were greater in smokers than in nonsmokers, in cigarette smokers than in pipe and cigar smokers, and in heavier than in lighter cigarette smokers. The changes were less in long-term former smokers and increased with age. Patterns in women were essentially the same.
• Limitations the authors state:
  • Some lungs had to be discarded, and the authors judged from their gross appearance that some of these were probably highly emphysematous
  • Some lungs yielded fewer than the full number of sections because of technical difficulties, loss of tissue or anatomic anomalies
  • Women were divided into only two cigarette-smoking groups because of small numbers

Topics

Medical terms in this study, explained in our Lexicon: Parenchyma, Autopsy, Emphysema, Fibrosis.

Browse return to medical research.