The effect of smoking intervention and an inhaled bronchodilator on airways reactivity in COPD: The Lung Health Study

Robert A. Wise, Richard E. Kanner, Paula Lindgren, John E. Connett, Murray D. Altose, Paul L. Enright, Donald P. Tashkin

Research output: Contribution to journalArticlepeer-review


Background: The Lung Health Study (LHS), a 5-year, randomized, prospective clinical trial, studied the effects of smoking intervention and therapy with inhaled anticholinergic bronchodilators on FEV1 in participants who were 35 to 60 years of age and had mild COPD. Participants were randomized into the following three groups: usual care; smoking cessation plus inhaled ipratropium bromide; and smoking cessation plus placebo inhaler. This report evaluates the effects of these interventions, demographic characteristics, smoking status, and FEV1 changes on airway responsiveness (AR). Methods and results: Of 5,887 participants, 4,201 underwent methacholine challenge testing both at study entry and study completion. All groups increased AR during the 5-year period. The increase in AR was greatest in continuing smokers and was associated with a greater FEV1 decline. An intent-to-treat analysis indicated no significant differences in AR changes among the three groups. Conclusions: Changes in AR over a 5-year period in the LHS were primarily related to changes in the FEV1. The greater the decline in FEV1, the greater the increase in AR. Smoking cessation had a small additional benefit in AR beyond its favorable effects on FEV 1 changes.

Original languageEnglish (US)
Pages (from-to)449-458
Number of pages10
Issue number2
StatePublished - Aug 1 2003


  • Airway hyperresponsiveness
  • Airways reactivity
  • COPD
  • Ipratropium
  • Methacholine bronchoprovocation challenge
  • Smoking cessation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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