{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:58:29Z","timestamp":1792277909086,"version":"4.4.0"},"reference-count":51,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"unspecified","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004411","name":"Heart and Stroke Foundation of Canada","doi-asserted-by":"publisher","award":["AWD-028717"],"award-info":[{"award-number":["AWD-028717"]}],"id":[{"id":"10.13039\/100004411","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["AWD-028717"],"award-info":[{"award-number":["AWD-028717"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000147","name":"Canadian Cancer Society","doi-asserted-by":"publisher","award":["AWD-028717"],"award-info":[{"award-number":["AWD-028717"]}],"id":[{"id":"10.13039\/501100000147","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021743","name":"Canadian Respiratory Research Network","doi-asserted-by":"crossref","award":["AWD-028717"],"award-info":[{"award-number":["AWD-028717"]}],"id":[{"id":"10.13039\/501100021743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,2,13]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The rapid growth in popularity of e-cigarettes over the past decade has prompted concerns about their impact on long-term respiratory health. Small airway injury is suspected to be a direct consequence of e-cigarette use and may be quantifiable by novel structural and functional diagnostic modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>In a multicentre observational longitudinal study, participants will be enrolled in either an adolescent (ages \u226512\u2009and &lt;19 years) or an adult arm (\u226519 years old) and followed over 3 years across three time points (baseline, 18 months and 36 months). In the adolescent arm, a total of 50 e-cigarette and 50 non-e-cigarette users will be enrolled across 4 sites. In the adult arm, a total of 100 e-cigarette users, 100 non-e-cigarette users, and an additional 100 combustible cigarette-only users and 100 dual combustible cigarette-e-cigarette users will be enrolled across 5 sites. Participants will undergo respiratory questionnaires, pulmonary function tests, oscillometry, cardiopulmonary exercise testing, hyperpolarised 129-xenon gas MRI and blood collection. In adolescent participants only, multiple breath washout and induced sputum collection will be performed. Adult participants will also undergo inspiratory\/expiratory chest CT and bronchoscopy. The primary endpoint will be a composite of small airway dysfunction according to oscillometry, cardiopulmonary testing and\/or chest imaging parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This protocol has been approved by The University of British Columbia-Providence Health Care Research Ethics Board (Certificate H24-00374). The use of hyperpolarised 129-xenon gas in this study has been approved by Health Canada (Certificate HC6-024-c291776). Written documentation of informed consent will be required prior to study initiation. We will seek to enrol adolescent participants who are capable of providing informed consent with an optional support statement from a parent encouraged but not required. Study findings will be disseminated to medical\/scientific audiences through scientific conferences and published manuscripts respecting the Strengthening the Reporting of Observational Studies in Epidemiology statement, to youths through outreach events at high schools and community programmes and through social media, and to adults through lung health community events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06819969\">NCT06819969<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-100568","type":"journal-article","created":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T07:15:56Z","timestamp":1741331756000},"page":"e100568","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["The Canadian Lung Outcomes in Users of Vaping Devices (CLOUD) Study: protocol for a prospective, observational cohort study"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06819969","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Paloma","family":"Burns","sequence":"first","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel L","family":"Eddy","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Division of Respiratory Medicine, Department of Pediatrics, British Columbia Children\u2019s Hospital, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Li","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Yang","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satvir S","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4057-6886","authenticated-orcid":false,"given":"Simon","family":"Couillard","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine et des sciences de la sant\u00e9, Universit\u00e9 de Sherbrooke, Sherbrooke, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K","family":"Stickland","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Guenette","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Svenningsen","sequence":"additional","affiliation":[{"name":"Firestone Institute for Respiratory Health, St. Joseph\u2019s Healthcare Hamilton; Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trisha","family":"Tulloch","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine, Hospital for Sick Children; Centre for Addiction and Mental Health; Division of Mental Health and Addiction, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasina","family":"Samji","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Prevention and Health Promotion Division, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Meza","sequence":"additional","affiliation":[{"name":"British Columbia Cancer Research Institute, Department of Integrative Oncology, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura L","family":"Struik","sequence":"additional","affiliation":[{"name":"School of Nursing, University of British Columbia Okanagan, Kelowna, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Aaron","sequence":"additional","affiliation":[{"name":"The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0412-6538","authenticated-orcid":false,"given":"Terence","family":"Ho","sequence":"additional","affiliation":[{"name":"Firestone Institute for Respiratory Health, St. Joseph\u2019s Healthcare Hamilton; Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Lam","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon","family":"Leipsic","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Maclean","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Department of Pediatrics, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Afshar","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo J","family":"Moraes","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Zanette","sequence":"additional","affiliation":[{"name":"Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giles","family":"Santyr","sequence":"additional","affiliation":[{"name":"Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois-Pierre","family":"Counil","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Universit\u00e9 de Sherbrooke, Sherbrooke, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana I","family":"Hernandez Cordero","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Matano","sequence":"additional","affiliation":[{"name":"BC Lung Foundation, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"de Arruda Maluf","sequence":"additional","affiliation":[{"name":"Capturing Health and Resilience Trajectories (CHART) Lab, Simon Fraser University Faculty of Health Sciences, Burnaby, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarus","family":"Leung","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Feng","sequence":"additional","affiliation":[{"name":"Capturing Health and Resilience Trajectories (CHART) Lab, Simon Fraser University Faculty of Health Sciences, Burnaby, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Bal","sequence":"additional","affiliation":[{"name":"Capturing Health and Resilience Trajectories (CHART) Lab, Simon Fraser University Faculty of Health Sciences, Burnaby, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harnoor","family":"Dhaliwal","sequence":"additional","affiliation":[{"name":"Capturing Health and Resilience Trajectories (CHART) Lab, Simon Fraser University Faculty of Health Sciences, Burnaby, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeola","family":"Mumuni","sequence":"additional","affiliation":[{"name":"Capturing Health and Resilience Trajectories (CHART) Lab, Simon Fraser University Faculty of Health Sciences, Burnaby, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlyn","family":"Lui","sequence":"additional","affiliation":[{"name":"Capturing Health and Resilience Trajectories (CHART) Lab, Simon Fraser University Faculty of Health Sciences, Burnaby, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Drew","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don D","family":"Sin","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H","family":"Rayment","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine, Department of Pediatrics, British Columbia Children\u2019s Hospital, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1682-6483","authenticated-orcid":false,"given":"Janice M","family":"Leung","sequence":"additional","affiliation":[{"name":"Centre for Heart Lung Innovation, The University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"2025121603274603000_15.3.e100568.1","unstructured":"Canadian tobacco and nicotine survey (CTNS): summary of results for 2022. Ottawa, ON Health Canada; 2023."},{"key":"2025121603274603000_15.3.e100568.2","unstructured":"Canadian community health survey. 2023. Available: https:\/\/www150.statcan.gc.ca\/t1\/tbl1\/en\/cv.action?pid=1310009601 [Accessed 04 Dec 2024]."},{"key":"2025121603274603000_15.3.e100568.3","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1007\/s10903-021-01229-0","article-title":"Racial and Ethnic Differences in E-Cigarette and Cigarette Use Among Adolescents","volume":"24","author":"Seo","year":"2022","journal-title":"J Immigr Minor Health"},{"key":"2025121603274603000_15.3.e100568.4","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2020-055669"},{"key":"2025121603274603000_15.3.e100568.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-13095-y","article-title":"Factors that influence the decision to vape among Indigenous youth","volume":"22","author":"Struik","year":"2022","journal-title":"BMC Public Health"},{"key":"2025121603274603000_15.3.e100568.6","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2020-055967"},{"key":"2025121603274603000_15.3.e100568.7","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1513\/AnnalsATS.202405-465VP","article-title":"The Fallacy of Electronic Cigarettes for Tobacco Dependence","volume":"21","author":"Farber","year":"2024","journal-title":"Ann Am Thorac Soc"},{"key":"2025121603274603000_15.3.e100568.8","doi-asserted-by":"crossref","first-page":"107891","DOI":"10.1016\/j.addbeh.2023.107891","article-title":"An 8-year longitudinal study of long-term, continuous users of electronic cigarettes","volume":"149","author":"Etter","year":"2024","journal-title":"Addict Behav"},{"key":"2025121603274603000_15.3.e100568.9","doi-asserted-by":"crossref","first-page":"317","DOI":"10.4046\/trd.2017.0080","article-title":"Small Airway Disease in Patients with Chronic Obstructive Pulmonary Disease","volume":"80","author":"Singh","year":"2017","journal-title":"Tuberc Respir Dis"},{"key":"2025121603274603000_15.3.e100568.10","doi-asserted-by":"crossref","first-page":"S671","DOI":"10.4103\/jpbs.JPBS_245_19","article-title":"The Development and Assessment of Modified Fagerstrom Test for Nicotine Dependence Scale among Malaysian Single Electronic Cigarette Users","volume":"12","author":"Rahman","year":"2020","journal-title":"J Pharm Bioallied Sci"},{"key":"2025121603274603000_15.3.e100568.11","doi-asserted-by":"publisher","DOI":"10.1081\/COPD-200050513"},{"key":"2025121603274603000_15.3.e100568.12","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00102509"},{"key":"2025121603274603000_15.3.e100568.13","doi-asserted-by":"publisher","DOI":"10.1378\/chest.93.3.580"},{"key":"2025121603274603000_15.3.e100568.14","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000078924.61453.FB"},{"key":"2025121603274603000_15.3.e100568.15","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01565-2024"},{"key":"2025121603274603000_15.3.e100568.16","first-page":"45","article-title":"Standardized respiratory questionnaires: comparison of the old with the new","volume":"119","author":"Comstock","year":"1979","journal-title":"Am Rev Respir Dis"},{"key":"2025121603274603000_15.3.e100568.17","doi-asserted-by":"crossref","first-page":"121","DOI":"10.18001\/TRS.1.2.2","article-title":"Validation of a Respiratory Symptom Questionnaire in Adolescent Smokers","volume":"1","author":"Cassidy","year":"2015","journal-title":"Tob Regul Sci"},{"key":"2025121603274603000_15.3.e100568.18","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1089\/ped.2011.0097","article-title":"Respiratory Symptoms After Smoking Cessation among College Students","volume":"24","author":"Calabro","year":"2011","journal-title":"Pediatr Allergy Immunol Pulmonol"},{"key":"2025121603274603000_15.3.e100568.19","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13223-017-0196-7","article-title":"Visual analogue scale (VAS) as a monitoring tool for daily changes in asthma symptoms in adolescents: a prospective study","volume":"13","author":"Rhee","year":"2017","journal-title":"Allergy Asthma Clin Immunol"},{"key":"2025121603274603000_15.3.e100568.20","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201509-1795OC"},{"key":"2025121603274603000_15.3.e100568.21","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01499-2021","article-title":"ERS\/ATS technical standard on interpretive strategies for routine lung function tests","volume":"60","author":"Stanojevic","year":"2022","journal-title":"Eur Respir J"},{"key":"2025121603274603000_15.3.e100568.22","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00753-2019","article-title":"Technical standards for respiratory oscillometry","volume":"55","author":"King","year":"2020","journal-title":"Eur Respir J"},{"key":"2025121603274603000_15.3.e100568.23","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00069712"},{"key":"2025121603274603000_15.3.e100568.24","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.167.2.211"},{"key":"2025121603274603000_15.3.e100568.25","doi-asserted-by":"crossref","DOI":"10.1155\/2013\/956081","article-title":"Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation","volume":"2013","author":"Guenette","year":"2013","journal-title":"Pulm Med"},{"key":"2025121603274603000_15.3.e100568.26","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1016\/j.chest.2022.01.021","article-title":"Using Cardiopulmonary Exercise Testing to Understand Dyspnea and Exercise Intolerance in Respiratory Disease","volume":"161","author":"Stickland","year":"2022","journal-title":"Chest"},{"key":"2025121603274603000_15.3.e100568.27","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-198205000-00012"},{"key":"2025121603274603000_15.3.e100568.28","doi-asserted-by":"crossref","first-page":"2966","DOI":"10.1002\/mrm.28985","article-title":"Protocols for multi-site trials using hyperpolarized 129 Xe MRI for imaging of ventilation, alveolar-airspace size, and gas exchange: A position paper from the 129 Xe MRI clinical trials consortium","volume":"86","author":"Niedbalski","year":"2021","journal-title":"Magn Reson Med"},{"key":"2025121603274603000_15.3.e100568.29","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214726"},{"key":"2025121603274603000_15.3.e100568.30","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202106-1440OC"},{"key":"2025121603274603000_15.3.e100568.31","doi-asserted-by":"crossref","DOI":"10.1186\/s12943-022-01544-6","article-title":"Distinct bronchial microbiome precedes clinical diagnosis of lung cancer","volume":"21","author":"Marshall","year":"2022","journal-title":"Mol Cancer"},{"key":"2025121603274603000_15.3.e100568.32","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1164\/rccm.202102-0289OC","article-title":"Effects of Inhaled Corticosteroid\/Long-Acting \u03b2(2)-Agonist Combination on the Airway Microbiome of Patients with Chronic Obstructive Pulmonary Disease","volume":"204","author":"Leitao Filho","year":"2021","journal-title":"Am J Respir Crit Care Med"},{"key":"2025121603274603000_15.3.e100568.33","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00688-2020","article-title":"ACE-2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19","volume":"55","author":"Leung","year":"2020","journal-title":"Eur Respir J"},{"key":"2025121603274603000_15.3.e100568.34","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1002\/ppul.25984","article-title":"Reference values for respiratory sinusoidal oscillometry in children aged 3 to 17 years","volume":"57","author":"Ducharme","year":"2022","journal-title":"Pediatr Pulmonol"},{"key":"2025121603274603000_15.3.e100568.35","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000001559"},{"key":"2025121603274603000_15.3.e100568.36","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00126212"},{"key":"2025121603274603000_15.3.e100568.37","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s12890-023-02380-0","article-title":"Structural features on quantitative chest computed tomography of patients with maximal mid-expiratory flow impairment in a normal lung function population","volume":"23","author":"Yang","year":"2023","journal-title":"BMC Pulm Med"},{"key":"2025121603274603000_15.3.e100568.38","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1159\/000478865","article-title":"A Novel Method of Estimating Small Airway Disease Using Inspiratory-to-Expiratory Computed Tomography","volume":"94","author":"Kirby","year":"2017","journal-title":"Respiration"},{"key":"2025121603274603000_15.3.e100568.39","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1164\/rccm.202210-1852LE","article-title":"Residual Volume versus FRC Computed Tomography Assessment of Functional Small Airway Disease in Smokers with and without Chronic Obstructive Pulmonary Disease","volume":"207","author":"Comellas","year":"2023","journal-title":"Am J Respir Crit Care Med"},{"key":"2025121603274603000_15.3.e100568.40","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2202033"},{"key":"2025121603274603000_15.3.e100568.41","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.chest.2021.10.046","article-title":"Significance of FEV3\/FEV6 in Recognition of Early Airway Disease in Smokers at Risk of Development of COPD","volume":"161","author":"Yee","year":"2022","journal-title":"Chest"},{"key":"2025121603274603000_15.3.e100568.42","doi-asserted-by":"crossref","first-page":"e69","DOI":"10.1016\/S2214-109X(22)00456-9","article-title":"Small airways obstruction and its risk factors in the Burden of Obstructive Lung Disease (BOLD) study: a multinational cross-sectional study","volume":"11","author":"Knox-Brown","year":"2023","journal-title":"Lancet Glob Health"},{"key":"2025121603274603000_15.3.e100568.43","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02398-2021"},{"key":"2025121603274603000_15.3.e100568.44","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00408-2019"},{"key":"2025121603274603000_15.3.e100568.45","doi-asserted-by":"publisher","DOI":"10.1172\/JCI95693"},{"key":"2025121603274603000_15.3.e100568.46","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120485"},{"key":"2025121603274603000_15.3.e100568.47","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00092.2013"},{"key":"2025121603274603000_15.3.e100568.48","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.22697"},{"key":"2025121603274603000_15.3.e100568.49","doi-asserted-by":"crossref","DOI":"10.1186\/gb-2013-14-10-r115","article-title":"DNA methylation age of human tissues and cell types","volume":"14","author":"Horvath","year":"2013","journal-title":"Genome Biol"},{"key":"2025121603274603000_15.3.e100568.50","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-021-00556-7"},{"key":"2025121603274603000_15.3.e100568.51","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-100568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:27:58Z","timestamp":1765884478000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-100568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":51,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3,6]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/bmjopen-2025-100568"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-100568","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}