RT Journal Article SR Electronic T1 Smoking strongly predicts disability retirement due to COPD: the Finnish Twin Cohort Study JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP erj00089-2010 DO 10.1183/09031936.00008910 A1 K. Koskenvuo A1 U. Broms A1 T. Korhonen A1 L. Laitinen A1 A. Huunan-Seppälä A1 T. Keistinen A1 I. Autti-Rämö A1 J. Kaprio A1 M. Koskenvuo YR 2010 UL http://erj.ersjournals.com/content/early/2010/06/01/09031936.00008910.abstract AB No previous studies on the association of smoking behaviour with disability retirement due to register verified chronic obstructive pulmonary disease (COPD) exist. This 30-year follow-up study examined how strongly aspects of cigarette smoking predict disability retirement due to COPD.The study population consisted of 24 043 adult Finnish twins (49.7% females) followed from 1975 to 2004. At baseline the participants had responded to a questionnaire. Information on retirement was obtained from the Finnish pension registers.Smoking strongly predicted disability retirement due to COPD. In comparison to never smokers, age adjusted hazard ratio (HR) for current smokers was 22.0 (95% CI 10.0–48.5) and for smokers with ≥12 pack-years 27.3 (95% CI 12.6–59.5). Similar estimates of risk were observed in within-pair analyses of twin pairs discordant for disability retirement due to COPD. Among discordant monozygotic pairs those with disability pension due to COPD were more often current smokers. The effect of early smoking onset (<18 years) on the risk of disability retirement due to COPD remained after adjustment for the amount smoked (HR 1.70, 95% CI 1.08–2.68).Smoking strongly predicts disability retirement due to COPD. Preventive measures against disability retirement and other harmful consequences of tobacco smoking should receive greater emphasis.