Zhenkun Liu,* Mingzhi Jiao,* Jiling Lv, Qizheng Han

Department of Respiratory Medicine, Shandong Second Provincial General Hospital, Jinan, Shandong, 250000, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jiling Lv, Department of Respiratory Medicine, Shandong Second Provincial General Hospital, No. 4 Duanxing West Road, Jinan, Shandong, 250000, People’s Republic of China, Tel +8615508603200, Email lvjiling1980@163.com Qizheng Han, Department of Respiratory Medicine, Shandong Second Provincial General Hospital, No. 4 Duanxing West Road, Jinan, Shandong, 250000, People’s Republic of China, Tel +8615168863190, Email hanqizheng@163.com

Objective: To investigate the impact of long-term passive smoking on the pathogenesis of chronic obstructive pulmonary disease (COPD) in women.
Methods: We conducted a community-based cross-sectional study involving 2,360 women aged ≥ 40 years in Jinan, China (October 1, 2022-April 30, 2023). Participants underwent comprehensive assessments including pulmonary function tests (spirometry), hematological analyses, and structured questionnaires evaluating COPD symptoms and passive smoking exposure. Based on exposure history, subjects were stratified into long-term passive smoking (LPS, n = 610) and non-passive smoking (NPS, n = 1,750) cohorts.
Results: Comparative analysis revealed significant pulmonary function impairment in the LPS group versus NPS controls: lower FEV1 (2.97± 0.61 vs 3.25± 0.37 L, p < 0.05), reduced FEV1% predicted (78.20± 10.18 vs 81.47± 14.69, p < 0.05), decreased FEV1/FVC ratio (83.32± 11.20 vs 87.23± 10.32%, p < 0.05). Small airway dysfunction was more pronounced in LPS participants, evidenced by: diminished MEF75% (77.58± 11.95 vs 86.08± 14.02 L/s, p < 0.05), reduced MEF50% (62.76± 19.79 vs 89.36± 16.78 L/s, p < 0.05), lower MMEF (80.87± 12.80 vs 87.46± 11.26 L/s, p < 0.05). The LPS group demonstrated: higher prevalence of preserved ratio impaired spirometry (PRISm, 5.74% vs 2.91%); increased annual exacerbation frequency (p < 0.05), elevated systemic inflammatory markers (p < 0.05), greater symptom severity (p < 0.05).
Conclusion: Our findings demonstrate that chronic passive smoke exposure constitutes an independent risk factor for COPD development in women, associated with higher disease prevalence, accelerated pulmonary function decline, increased exacerbation frequency and enhanced systemic inflammation.

Keywords: women, passive smoking, chronic obstructive pulmonary disease, pulmonary function, preserved ratio impaired spirometry