The epidemiologic literature concerning a relationship between a decreased FEV1 and mortality, morbidity and lung cancer was reviewed FEV1 is a very potent predictor of COPD mortality and morbidity, and of lung cancer. Furthermore, FEV1 is a hitherto largely unrecognized potent predictor of general mortality and cardiovascular mortality and morbidity. The consequence of this knowledge should be a more widespread usage of spirometry, both in epidemiologic studies and in daily clinical practice.