The Influence of Tobacco Use on Pulmonary Function in Elite Athletes

Objective: We sought to investigate the prevalence of smoking and lung function in the large cohort of elite athletes. Methods: This cross-sectional study included 804 athletes competing at international level who were consecutively examined from January to December 2017. Elite athletes were classified in four groups of sport disciplines (skill, power, endurance and mixed): skill (n = 141), power (n = 107), endurance (n = 105) and mixed sport disciplines (n = 451). All participants underwent pre-participation screening, including spirometry. Results: Study included 745 (92.7%) non-smokers, 20 (2.5%) former smokers and 39 (4.8%) active smokers. The percentage of body fat was higher and the percentage of muscle was lower in active smokers than in non-smokers and former smokers. Active smokers were more prevalent among skill and mixed than in power and endurance sports. FEV1 and FVC, as well as FEV1/FVC ratio, were significantly lower in active smokers than in non-smokers. There was no significant difference in PEF assessed in absolute values and in percentages. Forced expiratory flows, evaluated at the usual intervals (25%, 50% and 75% of FVC), were significantly lower in active smokers than in non-smokers. FEV1 and MEF25 were the lowest among active smokers in the skill sport group, whereas FEV1/FVC, MEF50 and MEF25 were the lowest among active smokers in the power sport group. In mixed and endurance disciplines there was no difference in pulmonary function between non-smokers, former smokers and active smokers. Conclusions: Pulmonary function was reduced in active smokers and these differences were the most prominent in skill and power sports. The percentage of body fat was the highest and percentage of muscle was the lowest in active smokers.