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The Lung Health Study (LHS) database largely fulfils these criteria.[20] We performed a secondary analysis on the data from the LHS research materials, as obtained from the National Heart, Lung and Blood Institute data repository information coordinating centre. The LHS is a large, multicentre, randomized, placebo-controlled clinical trial in adult smokers, with a 5-year follow-up period. The LHS studied the effect of intensive smoking cessation intervention and short-acting inhaled anticholinergic bronchodilator therapy with ipratropium on pulmonary function decline, overall morbidity and mortality in subjects with mild obstructive pulmonary disease.[15, 20] Their study protocol and SAHA HDAC concentration consent forms were approved by the institutional review boards of each of the 10 cooperating clinical GSK3B centres as well as the Data Coordinating Center before the initiation of the original study.[21] The LHS recruited 5887 smokers from the general population in North America between November 1986 and January 1988. At baseline, participants were 35�C60 years old, were current smokers and were at high risk for COPD as defined by a postbronchodilator forced expiratory volume in 1?s (FEV1) over vital capacity ratio www.selleckchem.com/products/tariquidar.html three times a day, or matching placebo treatment. A detailed description of the original LHS protocol has been published elsewhere.[20, 21] For the current analysis, we selected LHS participants who continued smoking throughout the study period as smokers and included non-smokers as those participants who were consistently abstinent ever since their first annual visit. We excluded recurrent smokers from our analysis. We considered participants who had been allocated to the ipratropium group as ��bronchodilator users�� and participants from the placebo group as ��non-bronchodilator users��. Participants from the usual care group were excluded as they did not receive any smoke intervention and were not blinded for bronchodilator therapy. We excluded participants that did not have any follow-up data. Participants were invited for annual visits to one of the 10 involved study centres. The visits included spirometry, health questionnaires, trial medication use and self-reported smoking. We included only participants whose smoking status was validated by exhaled carbon monoxide measurements.