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Smoking & Your Lungs


How Smoking Puts Your Lungs on an ‘Invisible Cliff’

If you smoke and can breathe without trouble, it’s easy to assume your lungs are as healthy as they ever were. But, all too often, that’s an illusion.

Nature blesses most of us with a pair of lungs more robust than we really need for everyday life. Even if you lose 30 percent of your lungs’ breathing ability, you’ve still got more than you need. It’s a blessing and a curse, because it means your lungs can be slowly getting worse without you knowing it.

But when your lung function dips below 60 percent or so, you start to notice that even normal activities, like walking up stairs, leave you winded. But by then it’s too late: Once it’s gone, lung function rarely recovers.

This disease goes by a lot of names, including emphysema and chronic bronchitis. But doctors call it chronic obstructive pulmonary disease, or COPD, and it’s the third-leading cause of death in the United States.

Victor Banzon, MD, a lung specialist with Beebe Pulmonary, tells his patients with COPD that they may feel generally healthy, as if they’re safe on the ground, so to speak.

“But the reality is COPD patients are on a cliff and we don’t know how high they are or how narrow that cliff is, but their lifeline is to stop smoking,” Dr. Banzon says.

If you smoke, you probably know the chemicals in cigarettes can up your chances of getting cancer. But lungs take a battering from cigarette smoke even without a tumor. And that long-term damage actually kills more Americans than lung cancer.

The vast majority of COPD cases are caused by smoking, but some non-smokers can get the disease.

What Does Smoking Do To Your Body?


How it happens

To understand what COPD looks like, consider the most common test for how well your lungs are working.

Take a deep breath, then force it out quickly (but don’t do this at home if you have a heart condition or recently had a heart attack). The percentage of breathing capacity that a healthy adult can exhale in one second changes based on age, height and gender. But it’s generally between 70 percent and 80 percent of your overall lung capacity.

It’s basically a way of determining whether your breathing is blocked (that’s where the “obstructive” part of COPD comes in). A COPD diagnosis, as well as the severity of the disease, is made based on these tests of lung function and the symptoms the patient experiences.

Smoking can chip away at your lung capacity in a number of ways. It can destroy the walls of air sacs that help you breathe, making it harder to move air through your lungs. Smoking can also cause your breathing tubes to swell up, producing mucus that can block them. The cough many smokers develop is the body’s way of trying to clear these airways.

No matter the cause, quitting smoking now can improve your chances.

If you stop smoking before you turn 30, you’ll have the same life expectancy after 35 as a non-smoker, Dr. Banzon said. But if you continue smoking after age 35, you can be expected to live 10 to 15 fewer years on average than a comparable person who hadn’t smoked.


A vicious cycle

If smoking made us gasp for air at the first puff, more of us would stop. But unless you exercise frequently, you don’t use everything your lungs have to offer.

“Because this process is so slow, patients don’t realize it until they ask a doctor why they’re seriously out of breath,” Dr. Banzon said. “However, by the time you really start to feel symptoms, the damage has already been done.”

Because people with COPD can find it difficult to exercise, they often move less, which only makes their symptoms worse.

At this point, the main goal of therapy is to preserve lung function, because lungs can’t heal this damage on their own.


E-cigarettes, Juul offer own risks

Because they don’t have as many cancer-causing agents as cigarettes, battery-powered devices that deliver nicotine — often referred to as e-cigarettes or by a brand name, JUUL — are sometimes seen as a safer alternative.

But it is too early to suggest e-cigarettes are safe, and what scientists do know should give us pause. Teens, especially, are more likely to use e-cigarettes, but they’re also more than three times more likely as non-users to start smoking within six months, according to the Centers for Disease Control and Prevention.

Furthermore, e-cigarettes still have nicotine, the most addictive part of cigarettes, and this chemical can harm brain development into the mid-20s. Finally, the gas exhaled by an e-cigarette user is not water vapor; in addition to nicotine, it contains tiny particles that can be inhaled into the lungs and cancer-causing chemicals.


Long-term consequences

Though it can be managed with portable oxygen machines and lung rehab programs that combine education, nutrition and exercise, COPD can have a catastrophic effect on people’s lives. Those with severe COPD may need help caring for themselves and are at higher risk for developing related medical problems including the following:

  • Heart disease
  • Lung cancer
  • Collapsed lung
  • Mental health disorders like depression and anxiety

That said, there are steps people with COPD can take to do more of what they enjoy. Task No. 1 is to quit smoking.

Dr. Banzon said science has found the best way to quit smoking is combining therapy with medication. Tremendous progress has been made even in the most recent decade. In 2005, about 21 of every 100 adults in the U.S. smoked. By 2016, that number was down to less than 16 in 100.

Sussex County has slightly more smokers than average, as an estimated 20 out of 100 residents are current smokers.

If you’re smoking and you want help to quit, Beebe Healthcare’s Quitline-trained counselors based in Lewes and Rehoboth are ready to help.

For more information, call (302) 645-3030 to make an appointment with a Quitline counselor at Beebe.


Beebe now offers a continuum of care for lung cancer patients. If you have been diagnosed with a pulmonary nodule or other lung cancer, call Beebe Cardiothoracic Surgery and ask about consulting with a specialist during an upcoming clinic: (302) 644-4282.



Victor Banzon

Victor Banzon, MD, went to medical school at St. George’s University School of Medicine in Grenada, and received his internal medicine training at Georgetown University, Washington, D.C. He completed his fellowship training in pulmonary and critical care at Maine Medical Center.