Work

Gender-Specific Association of Cigarette Smoking with Spirometry and Cardiopulmonary Exercise Parameters in Elite Athletes—Impact of Cigarette Smoking in Elite Athletes

Year: 2026

Type: article

Abstract: Background: The impact of cigarette smoking on cardiopulmonary function in elite athletes remains poorly characterised. This study aimed to evaluate the prevalence of smoking and its effects on pulmonary and exercise performance parameters among top-level competitors across different sport disciplines. Methods: 1005 Olympic-level athletes participating underwent comprehensive pre-participation screening, including spirometry and cardiopulmonary exercise testing (CPET). Smoking status was determined according to WHO definitions. Results: Among the 1005 athletes (53.4% males; mean age 26 ± 8.8 years), 117 (11.6%) were current smokers, predominantly males (70.9%). No smokers were identified among endurance athletes. Compared to non-smokers (n = 679), smokers were older (28 ± 5.8 vs. 25.5 ± 10.4 years, p = 0.026) and more frequently involved in mixed and skill disciplines (p = 0.043 and p = 0.006, respectively). In male smokers, spirometry revealed lower FVC (97.2 ± 10.3% vs. 101.1 ± 11.7%, p = 0.006), FEV1 (97.3 ± 12.4% vs. 101.4 ± 10.3%, p = 0.002), and MVV (p = 0.010). CPET showed reduced functional capacity (W/kg, p < 0.0001), lower VO2max (38.5 ± 7.8 vs. 42.2 ± 6.8 mL/min/kg, p < 0.0001), decreased O2 pulse (p = 0.007) and lower first and second ventilatory thresholds (respectively p = 0.025; and p = 0.004), Similar but less pronounced reductions in VO2max were found in female smokers (p = 0.003). Conclusions: Chronic smoking is associated with early spirometric and ventilatory impairments in elite athletes associated with lower aerobic capacity, despite their high levels of fitness. These effects are more marked in males, while females may exhibit partial protection. These findings highlight the importance of integrating smoking cessation and respiratory monitoring into athlete health programs.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm15072677