Guide to COPD (Chronic Obstructive Pulmonary Disease) and how smoking causes it.

smoking and copd
What is COPD?
COPD stands for Chronic Obstructive Pulmonary Disease, which basically is a disease that severely affects the lungs and respiratory system. Amongst other symptoms, breathing normally is made extremely difficult.

A person with COPD will gradually experience a decline in the function of their lungs, which will make daily life seem a struggle, as actions that were previously taken for granted, such as walking, sleeping or carrying out light housework, become laborious and tremendously hard work.

COPD usually refers to two different types of lung diseases, chronic bronchitis and emphysema, although people with COPD usually have both at the same time.
COPD does not happen overnight. Most people begin to develop symptoms when they are in their 40's although sufferers of COPD are usually diagnosed with the disease around the age of 75, once their lungs have been destroyed and the damage has been done.

The damage to the lungs is permanent and irreversible and there is no cure.

What are the causes of COPD?

Smoking is the main cause of COPD. If a person has never smoked, it would be very unlikely that he would develop COPD. Most sufferers of COPD are smokers or used to be smokers and between 80 - 90% of all deaths from COPD are due to smoking.

Tobacco smoke contains thousands of poisonous chemicals and toxins, which when breathed in, many of them settle in the lungs and cause disease if a build-up occurs, which will happen over time. The tar in cigarette smoke can be particularly damaging, as prolonged exposure can lead to the narrowing of the bronchioles and destruction of the lung's protection and filter system.

COPD is caused by a repeated and prolonged irritation of the lungs, normally spanning several decades of exposure, which is produced by breathing in harmful substances that get into the lungs and damage them permanently. These substances could be tobacco smoke, toxic chemicals, dust or air pollution.

A sufferer of COPD will most probably have developed chronic bronchitis before the emphysema develops although in the later stages of COPD, he is likely to have both diseases.

COPD Statistics

  • In the US COPD is the 4th leading cause of death, following lung cancer, heart disease and strokes.
  • In the US, over 120,000 people die a year from COPD. Most of them were smokers.
  • COPD claims the lives of around 30,000 people in the UK.
  • Smoking is the biggest risk factor for developing COPD.
  • Female deaths from COPD have now overtaken male deaths since the year 2000.
  • In the US in 2002, more than 61,000 females died of COPD compared to 59,000 males.
  • Women who smoke are 13 times as likely to die of COPD than women who have never smoked.
  • Men who smoke are 13 times as likely to die of COPD than men who have never smoked.
  • There are more female sufferers of chronic bronchitis than male sufferers (50% more).
  • Around 55% of emphysema sufferers are male and 45% are female. However, the trends seem to be reversing, as the number of female sufferers is increasing (around 5%) and the number of male sufferers is decreasing (around 10%).
  • Around 600,000 people have been diagnosed with COPD in the UK.
  • Heavy smokers are 30 times as likely to develop COPD.

How the lungs work

The lungs are responsible for delivering oxygen to the body and removing carbon dioxide from the blood. Healthy lungs mean that a person can breathe easily and can exercise without too much difficulty.

The lungs have the appearance of an upside down tree. The trachea, where air is first breathed into resembles the trunk of a tree. The trachea splits into two branches called the primary bronchi, where the air is next taken. One branch enters the left lung and the other branch enters the right lung.

From the primary bronchi, other smaller branches or air passages lead off deeper into the lungs, until at the end, you will find thousands of tiny round air sacs, which are called alveoli.

In healthy lungs, mainly found in non-smokers, these sacs easily fill up with air when we breathe in and deflate when carbon dioxide is breathed out. The alveoli are springy and spongy and the passageways that lead to the alveoli are unobstructed, wide and open.

In unhealthy lungs, mainly in smokers lungs with COPD, the air passages are partially blocked, inflamed or narrowed and the alveoli are damaged, as they are gradually made looser and become saggy and out of shape. The lungs elasticity is destroyed and this is what makes the expansion and contraction of the lungs less efficient and breathing becomes more laboured.

The lining of the lungs are covered with tiny hair like structures called cilia that continuously beat outwardly in order to sweep and clean harmful material out of the lungs. Poisonous chemicals and toxins that are inhaled into the lungs with the tobacco smoke, such as hydrogen cyanide paralyse the cilia and slow down their movement. This means that some of the chemicals will enter the lungs and remain there instead of being cleared. Over time, exposure to tobacco smoke will stop the cilia action altogether, dangerous chemicals will build up in the lungs, causing illness and the lungs will become more susceptible to viral infections and bacteria.

Quitting smoking will reverse this effect. The cilia will recover and the harmful substances will start to be cleaned out more efficiently from the lungs, eventually removing all traces of smoke particles from them. The process can be reversed as long as the smoker has not already developed COPD, in which case it would be better to give up smoking sooner rather than later.

Chronic bronchitis and the symptoms of chronic bronchitis

A smoker with COPD usually develops chronic bronchitis first and then emphysema afterwards. Most people generally associate bronchitis with severe chesty coughing otherwise known as a smoker's cough.

Chronic bronchitis is actually the inflammation of the bronchi, which is caused by a prolonged exposure to irritant substances, such as tobacco smoke. This inflammation causes excess mucous or phlegm to be produced as the body tries to protect itself from the harmful substances, which then in turn begins to block and congest the airways and the alveoli. This results in less oxygen being able to enter and exit the lungs, which leads to shortness of breath and a constant irritating cough.

Symptoms of chronic bronchitis

  • Persistent chronic cough
  • Excess mucous and phlegm being produced
  • Shortness of breath
  • Frequent clearing of the throat
  • Breathlessness
  • Mild chest pain
  • Cough that occurs in the winter and disappears in the summer

Emphysema and the symptoms of emphysema

Emphysema is a devastating disease, which is also referred to as "lung rot". It is irreversible and there is no cure for it. Sufferers of emphysema will see their quality of life decline drastically and daily life can become miserable and painful.

The main cause of emphysema is smoking. The tiny air sacs or alveoli at the bottom of the lungs, which cover a huge lung area, are surrounded by tiny blood vessels. Here, as the oxygen reaches the alveoli, it is absorbed by the blood vessels and then transferred into the bloodstream and to the rest of the body.

Smoking, or the chemicals released by the lungs to protect them from smoking, destroy the alveoli by breaking down the walls between them, thus creating larger, more floppy sacs and less of them. The elastic fibres of the air passages also become damaged and over-inflated, so that is becomes more difficult to move air in and out of the lungs.

As the alveoli are destroyed, this means that there is less surface area in the lungs for the exchange of gases, so less oxygen will be able to enter the blood stream. This can cause great difficulties in breathing, as the person often has to gasp for air and is easily left breathless.

Symptoms of emphysema

  • Shortness of breath on exertion (first signs)
  • Difficulty in breathing normally
  • Wheezing
  • Blue tint to the skin (cyanosis)
  • Coughing (with or without mucous)
  • Tiredness and fatigue
  • Grumpiness, irritability
  • Headaches, sleeping disorders

Treatment of COPD

Whilst there is no cure for COPD, there is treatment available to ease the symptoms and quality of life may see a slight improvement.

The first thing that sufferers of COPD should do is give up smoking. This will stop the disease from progressing even faster.
  • Stop smoking
  • Bronchodilator - drugs that open up the airways. They can be taken in the form of pills, liquids or from inhalers and they last for about 12 hours.
  • Inhaled glucocorticosteroids - can be prescribed to reduce the inflammation of the air passages and to reduce the amount of mucous being produced.
  • Exercise as much as possible to build up the strength of the lungs and heart.
  • Oxygen treatment - breathing in more oxygen through and cylinder, will keep oxygen levels up and improve breathing.
  • Breathing exercises.

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