['‘NOTICE', 'IF', 'THE', 'FILM', 'IMAGE', 'IS', 'LESS', 'CLEAR', 'THAN', 'THIS', 'SOTICE,', 'IT', 'IS', 'DUE', 'TO', 'THE', 'QUALITY', 'OF', 'THE', 'DOCRERT', 'BEING', 'FILMED.', 'For', 'most', 'of', 'the', 'United', 'States', 'population,', 'cigarette', 'smoking', 'is', 'a', 'much', 'greater', 'factor', 'in', 'the', 'development', 'of', 'COPD', 'than', 'air', 'pollution', 'or', 'occupational', 'exposure.', 'Cigarette', 'smoking', 'may,', 'however,', 'act', 'conjointly', 'with', 'atmospheric', 'pollution', 'or', 'occupational', 'exposure', 'to', 'produce', 'greater', 'mortality', 'and', 'morbidity', 'from', 'COPD', 'than', 'would', 'occur', 'from', 'one', 'exposure', 'tdctor', 'alone.', 'A', 'genetic', 'error,', 'homezygous', 'alpha;', '~antitrypsin', 'deficiency,', 'present', 'in', 'approximately', '1', 'in', '3,', '800', 'people', 'in', 'the', 'United', 'States,', 'has', 'been', 'associated', 'with', 'the', 'carly', 'development', 'of', 'severe', 'panacinar', 'emphysema.', 'A.ailable', 'evidence', 'doeg', 'not', 'permit', 'a', 'firm', 'conclusion', 'about', 'the', 'nature', 'of', 'the', 'inter-', 'action', 'between', 'smoking', 'and', 'this', 'condition.', 'Autopsy', 'studies', 'have', 'demonstrated', 'that', 'smokers', 'who', 'die', 'of', 'diseases', 'other', 'than', 'COPD', 'have', 'histologic', 'changes', 'characteristic', 'of', 'COPD', 'more', 'frequently', 'than', 'do', 'nonsmokers,', 'Experiments', 'in', 'both', 'animals', 'and', 'humang', 'have', 'demonstrated', 'that', 'the', 'inhalation', 'of', 'cigarette', 'smoke', 'is', 'associated', 'with', 'acute', 'and', 'chronic', 'changes', 'in', 'ventilatory', 'function', 'and', 'pulmonary', 'histology.', 'Cigarette', 'smoking', 'exerts', 'an', 'adverse', 'effect', 'on', 'the', 'pulmonary', 'clearance', 'mechanisms', 'including', 'ciliary', 'and', 'macrophage', 'function.', 'The', 'effect', 'of', 'cigarette', 'smoking', 'on', 'non-neoplastic', 'bronchopulmonary', 'disease', 'has', 'been', 'examined', 'in', 'detail', 'in', 'a', 'number', 'of', 'recently', 'published', 'epidemiological,', 'pathological,', 'and', 'experimental', 'studies.', 'In', 'addition', 'to', 'the', 'summary', 'presented', 'above', 'based', 'on', 'previous', 'reports', 'of', 'the', 'health', 'consequences', 'uf', 'smoking,', 'the', 'following', 'statements', 'are', 'made', 'to', 'emphasize', 'the', 'recent', 'developments', 'in', 'the', 'field:', 'res', 'j', ' ']