Bronchoalveolar lavage in smokers: quantification of alveolar macrophages and neutrophils as markers of bronchial obstruction.

Increased concentrations of neutrophils and alveolar macrophages are recovered in the bronchoalveolar lavage (BAL) of smokers compared with non-smokers. We designed a study to determine the relationship between neutrophils and alveolar macrophages recovered by BAL and the degree of air-flow obstruction, measured by spirometry (chronic air-flow obstruction was defined as: FEV1 < 80% of predicted and FEV1/FVC ratio < 70% of predicted) in healthy smokers. We found a significant correlation between spirometric values and the number of neutrophils and alveolar macrophages in BAL fluid obtained from healthy smokers. Our findings suggest that counts of 13-15x1000 neutrophils/ml and/or 430-450x1000 alveolar macrophages/ml in BAL fluid could be used as markers of air-flow obstruction in smokers.

Smoking cessation with a 16 h nicotine patch: results in a group of hospital workers.

As part of a programme for the implementation of a Smoking Control Policy in our hospital, an open study, without randomization, of 65 hospital workers, who wanted to give up smoking, was carried out. The characteristics of smoking in each subject were recorded. The Fagerstrom Questionnaire was used to measure the degree of dependence on nicotine. The treatment consisted of the daily use of 16 h nicotine patches for 12 weeks. During the first 4 weeks, the patches contained 15 mg of nicotine, for the second 4 weeks, 10 mg, and for the last 4 weeks 5 mg (per patch and day). Five visits were scheduled during the 26 week study period: at the start of the study and after 4, 8, 12 and 26 weeks. The abstinence was checked by measuring carbon monoxide in end-expiratory air. The success rate was 31% after 12 weeks, and decreased to 29% after 26 weeks. In conclusion, the nicotine patches appeared safe and effective in this study.