Effect of smoking cessation on pulmonary and cardiovascular function and structure: analysis of guinea pig model

To assess the pulmonary structural and functional effects of smoking cessation, we exposed groups of guinea pigs to cigarette smoke for 4 and 8 mo and included a group of animals in which smoke exposure was stopped at 4 mo (ex-smokers). We found that, compared with control nonsmokers, the smokers at both 4 and 8 mo showed airflow obstruction with alterations in lung volume and morphological evidence of emphysema with increased alveolar air space size and decreased alveolar surface area-to-volume ratio. There was an alteration in the pulmonary vascular structure, with increased numbers of muscularized arterioles, in the smokers at both time periods, and this was associated with significantly increased pulmonary arterial pressure at 8 mo. Cessation of smoke exposure appeared to halt, but not reverse, these structural changes. The smokers at 8 mo showed clear evidence for a "healthy smoker" effect, underscoring the necessity for longitudinal studies even when using an animal model. We conclude that cessation of exposure to cigarette smoke is associated with an apparent halt, but not a reversal, of emphysematous lung enlargement and pulmonary arteriolar muscularization. However, the magnitude of improvement in pulmonary function is not as great as the apparent structural differences would imply, and there is no clear effect on the pulmonary arterial pressure.