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Maximal expiratory flows (MEFs) depend on the elastic recoil pressure in the alveoli, airway resistance and bronchial collapsibility. MEFs at lower levels of vital capacity [MEFs at x% FVC (MEF(x))] would indicate the patency of peripheral airways. In Japan, a ratio of MEF(50) to MEF(25) (MEF(50)/MEF(25)) greater than 4.0 is used as an index of injury to the small airways in subjects without airflow limitation. However, to date there have been no epidemiological investigations relating to this index. The aim of this study was to evaluate the impact of cigarette smoking on MEFs in a general population, and to assess the validity of using this index to evaluate injury to the small airways.

Impact of Cigarette Smoking on Maximal Expiratory Flows in a General Population: the Takahata Study