Association of smoking with airflow limitation severity and complications in adult patients with COPD
Introduction: COPD is a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea, cough, sputum production, and/or exacerbations) caused by abnormalities in the airways and/or alveoli, leading to persistent and progressive airflow limitation. The Aim: This study aimed to examine the association between smoking, airflow limitation severity, and the development of complications in 131 patients treated at the Clinic for Pulmonology, University Clinical Center Niš, from January 2024 to March 2026. Results: Of 131 patients, 85 (64.89%) were men (mean age 68.02±8.86 years) and 46 (35.11%) were women (mean age 66.89±8.55 years). Patients were classified as current smokers 55 (41.98%), former smokers 55 (41.98%), and non-smokers 21 (16.04%). Severe COPD was most common 55 (41.98%), followed by moderate COPD 39 (29.77%), very severe COPD 34 (25.95%), and mild COPD 3 (2.29%). The longest disease duration was in non-smokers with severe COPD (17.80±14.23 years), while the longest smoking history was in patients with moderate COPD (54.67±24.16 pack-years). Current and former smokers differed significantly in smoking history. The highest FEV1 (%) was observed in non-smokers with moderate COPD (59.19±7.25). The longest duration of respiratory insufficiency and chronic cor pulmonale was found in non-smokers with very severe COPD (4.50±3.32 years). The duration of respiratory insufficiency and chronic cor pulmonale was associated with non-smoking status. Conclusion: Smoking status did not significantly affect bronchial obstruction severity. However, obstruction severity correlated with smoking duration (pack-years). Smoking significantly influenced COPD progression through the development of respiratory insufficiency and chronic cor pulmonale.