+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The 'healthy smoker': a phenomenon of health selection?

The 'healthy smoker': a phenomenon of health selection?

Respiration; International Review of Thoracic Diseases 57(3): 137-144

The detrimental effects of smoking on lung function have been recognized for several decades. Evidence comes from cross-sectional studies which emphasize that damage, certainly at the level of the small airways, may be detectable after a relatively short smoking history, and from longitudinal studies which show that smoking is associated with an increased rate of function loss over time. Implicit in most published evaluations of the evidence has been the concept that smoking is a habit taken up at random by the general population, and that those who do and do not take up the habit start out with similar levels of lung function. Published material was reviewed for evidence to the contrary, consistent with a health selection process similar to that shown in relation to workplace exposures and labeled the 'healthy worker' effect. Despite the wealth of published data on the topic of lung function in relation to the smoking habit, much is presented in a way which does not permit the concept of the 'healthy smoker' to be addressed. Nevertheless, this review revealed sufficient evidence from cross-sectional studies, as well as evidence from one longitudinal study to support the concept of the 'healthy smoker' as an individual who takes up the habit because his/her lungs are relatively resistant to the effects of smoking. If correct, this means that previous studies, particularly those which were cross-sectional in design and focussed on younger persons, are likely to have underestimated the consequences of smoking on lung function. The concept of the 'healthy smoker' may also throw light on characteristics which identify the 'susceptible smoker'.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 033826687

Download citation: RISBibTeXText

PMID: 2274712

Related references

Effects of the saline solution inhalation on the breathing pattern and occlusion pressure of smoker and non-smoker healthy subjects. European Journal of Clinical Investigation 24(SUPPL 2): A27, 1994

Acth and cortisol plasma levels modifications during oral nicotine administration from cigarette smoking in healthy smoker and non smoker subjects. Bollettino Societa Italiana Biologia Sperimentale 63(2): 139-142, 1987

Smoker, ex-smoker or non-smoker? The validity of routinely recorded smoking status in UK primary care: a cross-sectional study. Bmj Open 4(4): E004958-E004958, 2014

It is better to be a fat ex-smoker than a thin smoker: findings from the 1997-2004 National Health Interview Survey-National Death Index linkage study. Tobacco Control 23(5): 395-402, 2015

Passive smoking adversely affects the haemostasis/fibrinolytic parameters in healthy non-smoker offspring of healthy smokers. Thrombosis and Haemostasis 84(5): 923-924, 2000

Rebuttal to: Passive smoking adversely affects the haemostasis/fibrinolytic parameters in healthy non-smoker offspring of healthy smokers. Thrombosis and Haemostasis 85(4): 754-755, 2001

Smoker with Raynaud phenomenon and painful nodules on the legs. Actas Dermo-Sifiliograficas 104(8): 717-718, 2014

Higher leukocyte subpopulation counts in healthy smoker industrial workers than in nonsmoker industrial workers: possible health consequences. Acta Haematologica 129(4): 218-222, 2013

Internal migration and health: re-examining the healthy migrant phenomenon in China. Social Science & Medicine 72(8): 1294-1301, 2011

'Would you consider yourself a healthy person?': using focus groups to explore health as a moral phenomenon. Journal of Health Psychology 8(5): 501-514, 2009

Use of the current population survey to characterize subpopulations of continued smokers: a national perspective on the "hardcore" smoker phenomenon. Nicotine & Tobacco Research 6(4): 621-629, 2004

The cough reflex and the "healthy smoker". Chest 123(3): 660-662, 2003

Analysis of the lung microbiome in the "healthy" smoker and in COPD. Plos One 6(2): E16384-E16384, 2011

Smoking and adult asthma: a healthy smoker effect?. American Journal of Respiratory and Critical Care Medicine 165(11): 1566; Author Reply 1566-7, 2002

Desquamative interstitial pneumonitis in a healthy non-smoker: A rare diagnosis. Canadian Respiratory Journal 21(2): 86-88, 2014