In addition to lung cancer, smoking can cause or worsen other lung conditions, particularly chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, and asthma.
Smoking is a major risk factor for COPD, which is characterised by obstructed air flow into and out of the lungs. Chronic bronchitis and emphysema are the most important types of COPD. Bronchitis involves the inflammatory reaction in the airways, which leads to mucus over-production and swelling of the airways; emphysema involves the gas exchange part of the lung, the tiny sacs called alveoli. Destruction of these delicate structures leads to large non-functional spaces in the lungs, which have a limited to non-existent capacity to take up oxygen.
COPD can be managed in some cases, but there is no cure. People with this condition become progressively more disabled and in the final years of life are severely short of breath, often unable to lead a normal life and need to be maintained on continuous medical support systems and therapy. When the inflammatory response has, over a period of years, caused extensive damage to the small airways and alveoli, respiratory or heart failure can result. The World Health Organisation rates COPD as the fourth most common cause of death globally.
Asthma is characterised by episodes of shortness of breath and difficulty breathing. Smoking, both active and passive, worsens the condition and renders asthma medication less effective.
Asthma has become more prevalent in recent years, and smoking is suspected as one of the most significant causative factors.
Smoking counteracts the effects of asthma medication: the chemicals in smoke worsen the chronic inflammatory condition of the airways that the medicine attempts to alleviate. Asthmatics who smoke are also at increased risk of suffering potentially life-threatening asthma attacks.
All adults suffer a decrease in lung function as they age, but asthmatics lose lung function at a more rapid rate. The rate of deterioration is even greater in asthmatics who smoke.
Asthma and passive smoking
Passive smoking can both cause asthma and worsen an existing asthmatic condition. Children who grow up in a home where parents smoke are twice as vulnerable to asthma attacks, compared to children who live in a smoke-free environment.
Adult asthmatics are also affected by passive smoking, and many find it difficult to spend time in smokey environments because this aggravates their condition. Recent studies suggest that smoking can also cause asthma in adults, but this needs further research. There is no doubt that smokers exposed to asthma-triggering chemicals in the workplace are two or three times more likely to contract industrial asthma than non-smokers.
Prepare for the battle
Smoking deaths to double