Biomarkers in the Nose, Throat, and Lung Tissue of Smokers and Non-Smokers

Inclusion Criteria: 1. \- Adults \> 45 years of age, to be age matched with a previously enrolled cohort of current and ex-smokers with airflow obstruction and moderate atypia on sputum cytology, to be included in the following groups. 2. \- Non-smoking (less than 100 cigarettes per lifetime) controls \>50 years of age, to be age matched with a previously enrolled cohort with airflow obstruction (FEV1 \< 75% predicted and FEV1/FVC \< 75%) and moderate atypia on sputum cytology. 3. \- Current smokers with \> 30 pack years, no airflow obstruction (FEV1 \> 90% predicted) or lung cancer, \>50 years of age, to be age matched with a previously enrolled cohort with airflow obstruction and moderate atypia on sputum cytology . 4. \- No prior history of a head and neck or bronchogenic carcinoma. 5. \- Patients must be fully informed of the investigational nature of this study and must sign an informed consent in accordance with institutional and FDA guidelines. Exclusion Criteria: 1. \- Clinically apparent bleeding diathesis. 2. \- Cardiac dysrhythmia that is potentially life-threatening, such as ventricular tachycardia, multifocal premature ventricular contractions or supraventricular tachycardias with a rapid ventricular response. Well-controlled atrial fibrillation or rare (\< 2/minute) premature ventricular contractions are not exclusionary. 3. \- Hypoxemia (less than 90% saturation with supplemental oxygen) during bronchoscopy. 4. \- Evidence of clinically active coronary artery disease, including myocardial infarction within 6 weeks, chest pain, or poorly controlled congestive heart failure, or any other serious medical condition which would preclude a patient from undergoing a bronchoscopy. 5. \- Acute bronchitis or pneumonia within 8 weeks. 6. \- Inability to give informed consent. 7. \- Current smokers with no airflow obstruction may not have a history of coughing more than two times /week.