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Effects of contemporary filters on cigarette smoke.

risk of chronic bronchitis was greater in men than in women for all smoking categories, but no differences in pulmonary function were observed. The excess risk for men did not appear to be due to differences in cigarette consumption. In our own case control series at the Johns Hopkins Medical Institutions, the rate of aberrancy of forced expiration is greater in men than in women after adjustment for smoking habits and other factors. In a separate analysis of published data from the Johns Hopkins Medical Institutions,, male versus female differences were observed in the conEguration of flow volume loops. When compared with women, men have patterns of flow limitation similar to those of heavy smokers when compared with subjects who have never smoked. The pattern of male nonsmokers is similar to female heavy smokers. When comparing rates of decline in pulmonary function in our longitudinal observations , it is apparent that the largest rates of decline are observed in older male and female smokers and in older male nonsmokers. The explanation for the difference in pattern of pulmonary function deterioration in men versus women is not fully explained. It is probable that the pattern is shifted. This is intriguing because it suggests to us that some protective effect exists in women in the younger years. We have in the past characterized the early male response (abnormal spirometry) as an " airways " response and the female response (abnormal Dco) as a " vascular " response to the effects of smoking .1 It is possible that hormonal factors play some role in modifying the response. If, in fact, the pattern of pulmonary function deterioration is different and a protective effect exists; (all worthy of further exploration) then these results have important implications for work evaluating the effects of smoking, environmental factors and occupational exposures on pulmonary function both at an epidemio-logic and mechanistic or physiologic level.