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Cardiorespiratory and immune response to physical activity following exposure to a typical smoking environment
  1. Andreas D Flouris1,
  2. Giorgos S Metsios1,
  3. Athanasios Z Jamurtas2,
  4. Yiannis Koutedakis2
  1. 1FAME Laboratory, Institute of Human Performance and Rehabilitation, Centre for Research and Technology Thessaly, Greece
  2. 2Department of Exercise Sciences, University of Thessaly, Trikala, Greece
  1. Correspondence to Dr Andreas D Flouris, FAME Laboratory, Institute of Human Performance and Rehabilitation, Centre for Research and Technology Thessaly, Karies, Trikala 42100, Greece; aflouris{at}


Objective Millions of non-smokers suffer daily passive smoking (PS) at home or at work, many of whom then have to walk fast for several minutes or climb a few sets of stairs. We conducted a randomised single-blind crossover experiment to assess the cardiorespiratory and immune response to physical activity following PS.

Design Data were obtained from 17 (eight women) non-smoking adults during and following 30 minutes of moderate cycling administered at baseline and at 0 hour, 1 hour and 3 hours following a 1-hour PS exposure set at bar/restaurant PS levels.

Results We found that PS was associated with a 36% and 38.7% decrease in mean power output in men and women, respectively, and that this effect persisted up to 3 hours (p<0.05). Moreover, at 0 hour almost all cardiorespiratory and immune variables measured were markedly reduced (p<0.05). For instance, FEV1 values at 0 hour dropped by 10.2% in men and 10.8% in women, while IL-5 increased by 59.2% in men and 44% in women, respectively (p<0.05). At 3-hour mean values of respiratory quotient, mean power, perceived exertion, cotinine, FEV1, IL-5, IL-6 and INFγ in both sexes, recovery diastolic and mean arterial pressure, IL-4 and TNFα in men, as well as percentage predicted FEV1 in women remained different compared to baseline (p<0.05). Also, some of the PS effects were exacerbated in less fit individuals.

Conclusion It is concluded that 1 hour of PS at bar/restaurant levels adversely affects the response to moderate physical activity in healthy non-smokers for at least 3 hours following PS.

  • Secondhand smoke
  • exercise
  • cotinine
  • respiration
  • inflammatory markers
  • smoking
  • cytokines

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  • All authors contributed equally to this work.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the University of Thessaly Ethics Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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