Dear Dr. White:
I am only 37 years old, too young to be diagnosed with Chronic Obstructive Pulmonary Disease (COPD), but that’s what the doctor told me yesterday. I thought it was asthma because my symptoms are almost exactly like my husband and 9-year-old son, both of whom have asthma. COPD happens to old people, doesn’t it? I have only smoked for 20 years. I presently manage a restaurant and just can’t be coughing like this. I know I should quit smoking and I am going to try, but COPD? Help!
C.G., Chevy Chase, MD
Smoking-related chronic obstructive lung disease (COPD) can cause a constellation of symptoms very similar to asthma, including cough, wheeze, increased airway mucus production, and shortness of breath. Both disorders are characterized by blockage of the airways, but in asthma the blockage is intermittent and reversible, while in COPD the blockage is fixed.
Although the symptoms are similar, the underlying problems are different. Smoking causes progressive damage to the airway tissue that is irreversible, leading to trapping of air in the lungs and/or increased mucus that plugs the airways, causing cough and shortness of breath, and setting the stage for pulmonary infections such as bronchitis or pneumonia.
The risk of developing COPD is determined not only by how long a person smokes, but also by how heavily they smoke and how “strong” the cigarettes are. Thus, a person smoking one pack of cigarettes per day for 20 years is at the same risk as a person smoking two packs of cigarettes a year for 10 years or four packs a day for five years. The younger a person is when they start smoking, especially if they smoke during or before adolescence, the more likely they are to develop COPD. Continued smoking can lead to progressively more debilitating COPD; however, the good news is that if you stop smoking, you can prevent further damage to the lungs.
There are medications, some of which are now available over-the-counter, which may help individuals to quit; however, there’s nothing to substitute for good old-fashioned determination in smoking cessation. Please be aware, though, that some people temporarily feel a little worse right after they stop smoking. Don’t let that discourage you.
For people with severe COPD, there are pulmonary rehabilitation programs that can help. These are often located at hospitals and usually involve a time-intensive initial phase, followed by long-term follow-up sessions. You didn’t say how severe your COPD was, but it’s usually pretty mild at your age, so now is definitely the time to throw away the cigarettes before things get worse. Good luck — you’ve already taken the first step by trying to learn about COPD.
Martha White, MD, is director of research at the Institute for Asthma and Allergy in Wheaton, MD and medical editor of The MA Report.
First published: The MA Report, September 2003
Reviewed: February 2009