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Smoking, acute mountain sickness and altitude acclimatisation: a cohort study
  1. Tian-Yi Wu1,2,3,
  2. Shou-Quan Ding4,
  3. Jin-Liang Liu4,
  4. Jian-Hou Jia4,
  5. Zuo-Chun Chai4,
  6. Rui-Chen Dai4,
  7. Ji-Zhui Zhao5,
  8. Qi De Tang5,
  9. Bengt Kayser6
  1. 1Physiological Research Group of the Ministry of Railroad, Beijing, People's Republic of China
  2. 2National Key Laboratory of High Altitude Medicine, High Altitude Medical Research Institute, Qinghai, People's Republic of China
  3. 3High Altitude Medical Research Center, University of Tibet, Lhasa, Tibet, People's Republic of China
  4. 4Qingai-Tibet Railroad Hospitals of the Construction Company, Golmud, People's Republic of China
  5. 5China Railroad Construction Company, Beijing, People's Republic of China
  6. 6Institut des sciences du mouvement et de la médecine du sport, Faculté de médicine, Université de Genève, Geneva, Switzerland
  1. Correspondence to Dr Tian Yi Wu, National Key Laboratory of High Altitude Medicine, High Altitude Medical Research Institute, Xining, Zhuanchang Rd, No. 7, Qinghai 810012, People's Republic of China; wutianyiqg{at}


Rationale The relationship between cigarette smoking and acute mountain sickness (AMS) is not clear.

Objective To assess AMS risk and altitude acclimatisation in relation to smoking.

Methods 200 healthy non-smokers and 182 cigarette smokers were recruited from Han lowland workers. These were men without prior altitude exposure, matched for age, health status and occupation, who were transported to an altitude of 4525 masl.

Measurements AMS, smoking habits, arterial saturation (SpO2), haemoglobin (Hb), lung function and mean pulmonary artery pressure (PAPm) were assessed upon arrival and after 3 and 6 months.

Main results Compared with non-smokers, smokers had a lower incidence of AMS and lower AMS scores than non-smokers upon arrival; higher Hb and PAPm associated with lower SpO2 at 3 and 6 months at altitude; and lower forced expiratory volume in 1 s and maximal voluntary ventilation at 3 and 6 months.

Conclusions Smoking slightly decreases the risk of AMS but impairs long-term altitude acclimatisation and lung function during a prolonged stay at high altitude.

  • Cigarette smoking
  • high mountains
  • oxygen saturation
  • haemoglobin
  • lung function
  • pulmonary artery pressure

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  • Funding This study was supported by competitive grants NNSF-30393130, 973-2012CB518202 and EAF XZ-101, People's Republic China.

  • Competing interests None.

  • Ethics approval China National Science Foundation (NNSF) and the Qinghai High Altitude Medical Research Institute Committee on Human Research.

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

  • Data sharing statement Any interested scholars can ask the corresponding author for an access to the original data.