RT Journal Article SR Electronic T1 Characteristics and consequences of chronic obstructive pulmonary disease in never smokers JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 4867 VO 42 IS Suppl 57 A1 Mette Thomsen A1 Børge Nordestgaard A1 Jørgen Vestbo A1 Peter Lange YR 2013 UL http://erj.ersjournals.com/content/42/Suppl_57/4867.abstract AB Background: A substantial proportion of patients with chronic obstructive pulmonary disease (COPD) have never smoked. Whether characteristics and consequences of COPD in this group are different from smokers is unknown.Methods: We examined 68501 participants from the general population and identified 1,476 never smokers, 2696 former smokers, and 2451 current smokers with spirometrically defined COPD. Characteristics, symptoms, disease severity, and levels of inflammatory biomarkers were examined at baseline. Risk of lung-related hospitalizations, cardiovascular comorbidities, and all-cause mortality was assessed during a median follow-up of 4 years. For comparison we included 24529 never smokers without COPD.Results: Never smokers had fewer symptoms, milder disease, and no evidence of systemic inflammation compared to former and current smokers. However, multivariably adjusted hazard ratios for pneumonia were 1.9(95% confidence interval, 1.4-2.6) in never smokers, 2.9(2.4-3.4) in former, and 3.7(3.1-4.4) in current smokers compared to never smokers without COPD. Corresponding hazard ratios for COPD hospitalization were 8.6(5.3 -14), 30(22-41), and 43(32-59), respectively. For lung cancer, corresponding hazard ratios were 11(5.7-23) in former and 18(9.2-35) in current smokers, while there were no cases of lung cancer among never smokers. Furthermore, risk of cardiovascular comorbidities and all-cause mortality was increased in former and current smokers, but not in neversmokers with COPD.Conclusion: Compared to current and former smokers, neversmokers with COPD have a milder disease which is limited to the lungs; however, morbidity due to lung-related hospitalizations is substantial.