Respiratory Disease Risks in Smokers
By Peter Howells
It is well documented that smoking causes cancer and more specifically lung cancer. Indeed, smoking is responsible for lung cancer in 80% of female cases and 90% in male cases in western society. Alarmingly, 25% of all smokers who die prematurely from their smoking induced illness will die from lung cancer. However, an oft-overlooked aspect of smoking is the ‘nearly as common incidence of chronic obstructive pulmonary (lung) disease. (Just to highlight a common misconception, chronic means ‘over a long period of time and not acute, which is short-lived. People often confuse the two.)
The definition of COPD, as recognised by both the American Thoracic Society and the European Respiratory Society, is a disorder that is characterised by reduced maximal expiratory flow and slow forced emptying of the lungs features that do not change markedly over several months. This limitation in airflow is only minimally reversible with bronchodilators (drugs that ease the flow of air in the lung). Or to put it in layman s terms - your lungs don t function properly any more and you cannot breath properly!
Chronic Obstructive Pulmonary Disease or COPD is responsible for the premature deaths of 21% of all smokers. Combined, Lung Cancer and COPD are responsible for 45% of smoking related deaths in the UK every year. To put that in real, horrific numbers, that is over 51,000 people, more than the population of Durham or the equivalent of 228 Boeing 757 aircraft crashes every year!
Whilst these figures are quite devastating, smokers often overlook COPD as a life threatening disease. However, it is reasonable to believe that if smokers became more aware of the suffering associated with COPD, it should give them ample motivation to quit smoking.
There are two main diseases associated with COPD and to a lesser extent asthma is also a factor. The main diseases are emphysema and chronic bronchitis. Most people diagnosed with COPD manifest symptoms of both diseases although the amount of each form of ailment can vary dramatically from patient to patient.
Emphysema is a hugely debilitating disease resulting in chronic shortage of breath. Sufferers are unable to exercise and in the most severe cases, they are unable to undertake any physical activity. It is characterised by the destruction of the alveoli of the lungs. These air sacks become damaged through cigarette smoke over a long period of time. This results in a reduction of lung surface area, which in turn means the sufferer cannot obtain adequate oxygen from breathing.
A second characterisation is the destruction of elasticity within the lung tissue itself. This is caused by the metabolic interference of chemicals in cigarette smoke with cells within the lung. The resulting interference means that smokers produce greater levels of the enzyme elastase within the lung that destroys the elastin proteins within lung tissues, thus reducing the elasticity of the tissues.
This reduction of elasticity means that sufferers of emphysema have to work harder to breath. In its milder forms, this can be witnessed in sufferers pursing their lips when breathing. Sufferers also tend to have larger chests as a result of the use of more muscles in breathing to overcome the lack of elasticity within their lung tissues. In the very worst cases, sufferers must keep an oxygen bottle with them at all times in order to live with any level of normality.
COPD sufferers also demonstrate chronic bronchitis. Chronic bronchitis is defined clinically by the presence of chronic bronchial secretions, enough to cause expectoration, occurring on most days for a minimum of three months of the year for two consecutive years. Basically, if the person coughs up phlegm on consecutive days over three months (usually during winter), they can be deemed to be suffering from chronic bronchitis.
Smokers often refer to their bronchitis as a ’smokers cough without thinking the actual cause could be the primary stages of COPD.
Diagnosis of COPD is done through both physical examinations, imagery techniques such as X-ray and high definition CT scans and through lung function tests. Lung function tests measure flow rates, volume and residual volumes and are compared against known healthy averages to determine whether a subject can be diagnosed with the illness. Further to these methods, doctors can measure gas transfer efficiency in the lungs and monitor blood oxygen levels and compare the efficiency of the lung when using bronchodilators.
Treatments for COPD are purely based on managing the disease. There are no cures for COPD and death comes slowly through lack of breath. One of the main treatments to manage the disease is of course the cessation of smoking. In younger smokers damage done to the lung can be reversed naturally by the body, however, in middle age and older smokers, the damage is irreversible. Nevertheless, quitting smoking will stop the increased rate of damage being done and can only have a positive benefit to the smoker.
A useful exercise for current smokers to undertake to understand the suffering caused by emphysema is this take a deep breath, then breath in some more air on top of what you have already - now start doing things using only what capacity is left in your lungs. Try going upstairs or walking to the shop and back with only this much lung capacity. It is easy to see what a debilitating disease emphysema is when you have tried this exercise.
It is a tedious and lengthy process to die by COPD but knowing this should encourage smokers to think very hard about their addiction to nicotine and their potential painful death as a result. Quitting smoking id the single biggest step a smoker can make to improving their health.
Pete Howells owns the website http://easyquitsystem.com and has devised a simple system that will help any smoker quit by giving them the instructions they need to follow to achieve their ambition to quit. Please visit http://easyquitsystem.com to find out more about his incredible process for quitting smoking.
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