Among the participants who had never smoked, the age-standardized rate of death from chronic obstructive pulmonary disease (COPD) remained relatively constant for women (Table 2) but decreased by approximately 45% for men from the 1982–1988 period to the contemporary period (Table 3). In contrast, mortality increased for both male and female smokers across all three periods (Tables 2 and 3 and Fig. 1). The largest absolute increase in COPD mortality occurred among male smokers after the 1980s, affecting all smokers who were 55 years of age or older (Fig. 1) and all birth cohorts from 1900 through at least 1954 (Fig. S1 in the Supplementary Appendix). The multivariable adjusted relative risk of death from COPD among male smokers more than doubled from the 1982– 1988 period (9.98 [95% CI, 7.97 to 12.49]) to the contemporary period (25.61 [95% CI, 21.68 to 30.25]) (Table 3). Approximately half this increase reflected the lower background death rate among men in the contemporary period who had never smoked, as compared with those in the 1982– 1988 period. The relative risk for female smokers also
