The Tobacco Reference Guide by David Moyer

The Tobacco Reference Guide

by David Moyer, MD.

Chapter 10 Chronic obstructive pulmonary disease (COPD),

emphysema, and other lung disease

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There are 14 million patients with COPD (chronic obstructive pulmonary disease) in

the United States, an increase of 40% since 1982. 1.5 million of these have

emphysema; the rest have the chronic bronchitis type of COPD. It is the fourth leading

cause of death by diagnosis in this country, and mortality from COPD has increased

by 71% since 1982. 80 to 90% of cases are caused by smoking, and the increased

risk is thirty-fold for heavy smokers compared to nonsmokers. Only about 15% of

smokers develop overt COPD. However, all smokers have an accelerated loss of

pulmonary function with increasing age, and more than half of one pack per day

middle age smokers complain of chronic cough.

Michael S. Stulbarg, M.D. Audio Digest Internal Medicine, November 6, 1996

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Mean lung function measured by FEVI (forced expiratory volume in one second)

averages 23% lower in male smokers and 18% lower in female smokers compared

with never smokers of the same age and height. Measurement of lung function

identifies smokers at increased risk of disease and death, and the concept of "lung

age" (telling a smoker "you have the lung capacity of nonsmoking 70-year-old") may

have a powerful effect in motivating smoking cessation.

Journal of the American Medical Association, June 2, 1993, pp. 2741 and 2785

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In COPD, patients who are successful in smoking cessation experience an actual

improvement in lung function over the first 2 to 3 years after quitting, as well as a

decrease in the rate of age-related decline of lung function thereafter.

Journal of the American Medical Association, November 16, 1994, p. 1540

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If Americans did not smoke, there would be 85% less emphysema and chronic

bronchitis, 90% less lung cancer, and 33% less heart disease.

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