Smoking and COPD

By Bonnie Steele. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Though he gave up smoking more than 30 years ago, actor Leonard Nimoy has recently announced he is suffering from chronic obstructive pulmonary disease (COPD). The 82-year-old "Star Trek" star says the progressive respiratory disease, typically caused by years of smoking, has caused him to slow down considerably.

Nimoy’s diagnosis isn’t unusual: COPD usually doesn’t develop until middle age or later, often years after you or someone you love has finally stopped smoking.

In fact, COPD is an umbrella term that includes chronic bronchitis, emphysema or a combination of conditions. It affects more than 12 million people in the U.S. today, making it the third leading cause of death after heart disease and cancer, according to the American Lung Association.

“Emphysema is the physical destruction of lung tissue,” says physician Joseph Pinzone, MD, assistant medical director of AMAI, an Innovative Medical and Wellness Practice, Inc. and assistant clinical professor of Medicine at the David Geffen School of Medicine at UCLA.

Pinzone says that after initial lung damage, “There’s substantially less lung surface for an effective, continuous oxygen transfer. Therefore, as emphysema progresses, so does COPD.”

Is It Difficult to Catch Your Breath? 

Doctors commonly use spirometry to diagnose COPD. The painless test involves blowing into a tube to measure how much  — and how quickly and efficiently  — you can exhale to determine the health of your lungs.

As lung functions begin to decline with age, chronic inflammation and loss of elasticity in the lung air sacs (caused by exposure to smoke) leads to the following symptoms:     

  • Chronic cough or a cough that produces a lot of mucus,
  • Shortness of breath that may limit physical activity and functionality,
  • Wheezing,
  • Excessive tiredness, and
  • Chest tightness.

While smokers often have a chronic cough, Pinzone notes that there is a difference between a smoker’s cough and COPD. “A smoker’s cough is intermittent and does not limit your everyday activity,” he explains. “It typically arises around the time a person smokes a cigarette.” On the other hand, COPD is a chronic drawn-out cough, often occurring all day long.

“The most common cause of COPD is smoking, so someone could, ostensibly, have both types of cough,” says Pinzone.

Next Steps

Unfortunately, there is no cure for COPD, but quitting smoking can ease the harsh symptoms. “Your progression is variable,” says Pinzone. “For the typical person with COPD, the long-term disease progresses over years. However, some people have genetic predispositions that make the progress faster.”

In addition to quitting smoking:

  • There are a variety of medications that can be prescribed to ease COPD symptoms. “Some are designed to decrease inflammation; some open the airways; and some have other actions,” says Pinzone.
  • Annual flu shots are strongly encouraged, as even mild influenza can lead to serious complications for COPD sufferers.
  • More severe symptoms might require pulmonary oxygen therapy. A health care practioner might prescribe pulmonary rehabilitation, specific exercises, nutrition tips and methods to control breathing.

For Caregivers

Symptoms of breathlessness and daily fatigue are debilitating, and may worsen before a smoker with COPD is motivated to stop smoking. For many, a huge part of dealing with COPD is the decision to quit smoking, or helping to motivate someone you love to quit.

In addition, says Pinzone, many health care providers are unwilling or hesitant to provide medications that inhibit chronic coughing because it’s important to clear mucus (e.g., sputum or phlegm) out of breathing passages. Also, cough suppressants may increase the risk of infection in people with COPD.

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