The impact of smoking on respiratory rehabilitation efficacy and correlation analysis in patients with chronic obstructive pulmonary disease: a retrospective study

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Key findings

• Non-smokers showed significant improvements in forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), FEV₁/FVC ratio, maximal voluntary ventilation, and diffusing capacity of the lung for carbon monoxide compared to smokers after rehabilitation.

• Non-smokers demonstrated greater enhancements in 6-minute walk distance and peak oxygen consumption post-rehabilitation compared to smokers.

• Non-smokers had significantly better scores in St. George’s Respiratory Questionnaire, Medical Research Council dyspnea scale, and sleep quality assessments compared to smokers following rehabilitation.

What is known and what is new?

• Smoking induces chronic inflammation, oxidative stress, premature aging, and immune dysfunction in the lungs, leading to progressive damage of the airway epithelium, vascular endothelium, small airways, and alveoli, characteristic of chronic obstructive pulmonary disease (COPD).

• Smoking cessation as a critical factor in achieving optimal outcomes in pulmonary rehabilitation programs, influencing both physiological improvements and quality of life enhancements among patients with respiratory conditions.

What is the implication, and what should change now?

• Smoking significantly diminishes the effectiveness of respiratory rehabilitation in COPD patients, resulting in inferior improvements in pulmonary function, exercise capacity, quality of life, and sleep patterns compared to non-smokers.

Publication:  Li M, Gao W. The impact of smoking on respiratory rehabilitation efficacy and correlation analysis in patients with chronic obstructive pulmonary disease: a retrospective study. J Thorac Dis 2025;17(1):254-264. doi: 10.21037/jtd-24-1267