Why has spirometry been so slow to be accepted in the mainstream of clinical practice? The author believes that spirometry has been couched in too much mystique. It also has required the careful study of structure?function relationships of the human lung to understand what causes alterations in spirometric measurements. Longitudinal studies have helped clarify the clinical significance of tests purported to indicate early stages of chronic obstructive pulmonary disease (COPD). Also, in the past, inexpensive and user-friendly devices were not available for office and clinic use. All of this is changing rapidly. Now the primary care physician and his or her assistant can learn the basics of spirometry easily, which provides two main values¡ªthe forced vital capacity (FVC) and the forced expiratory volume in 1 second (FEV