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Millions of smokers who pass a widely used lung test may nevertheless be in the early stages of chronic obstructive pulmonary disorder (COPD), according to a new study.

The researchers, led by Dr. Elizabeth Regan of National Jewish Health in Denver, found signs of lung disease in 55 percent of long-term smokers who had passed a spirometer test.

Spirometer tests measure how much air a patient can blow out of their lungs. But when researchers examined additional factors, such as the results of CT scans and medication usage, they discovered that many of these “disease-free” smokers actually had a respiratory problem.

“We hope these findings will help debunk the myth of the healthy smoker and highlight the importance of smoking prevention and cessation to prevent lung disease and other long-term effects of smoking,” Regan said.

The researchers examined nearly 9,000 participants between 45 and 80 years old who had smoked at least one pack of cigarettes per day for ten years. Spirometer tests designated nearly half of these smokers as healthy. However, on further examination researchers found signs of emphysema in 42 percent of participants and shortness of breath in 23 percent.

“Smokers who have ‘normal’ lung-function tests often have significant respiratory disease. Many of those smokers likely have the early stages of chronic obstructive pulmonary disease,” said Regan.

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