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Kick the Habit!
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If you have COPD, it pays to quit smoking
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By Natasha Persaud
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MediZine's Healthy Living Fall 2009
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 If you have one of the conditions that fall under the term chronic obstructive pulmonary disease (COPD)—and 25 percent of regular smokers do—the most important step you can take to improve your health is to quit smoking.
The main forms of COPD are emphysema and chronic bronchitis, both progressive lung diseases that make breathing difficult. Smoking is by far the leading cause of COPD, although secondhand smoke, air pollution, infection and allergies can play a role or worsen the disease.
Quitting smoking now can offer some significant health benefits, according to Norman Edelman, M.D., chief medical officer of the American Lung Association. Here he answers questions and offers tips to improve your chances of success.
A substantial body of research shows it’s worthwhile to quit, no matter how advanced your COPD. The day you quit, risks for heart disease and stroke go down. Within a few months, lung deterioration slows and your lung cancer risk is cut. Within nine months of smoking cessation, coughing, sinus congestion, fatigue and shortness of breath from COPD also decrease.
The basic issues are surprisingly the same. Some people with COPD say they experience worse coughing when they try to quit, but that’s actually a good thing. It means that the tiny hairs that keep the lungs clear of phlegm—which are destroyed by smoke—have regrown.
A doctor can be a powerful ally when he or she discusses the risks of smoking, explains your medical condition and helps you make decisions about treatment. Your physician can advise you as to whether you should use medication and, if so, which one.
For ongoing support, your doctor can refer you to a smoking-cessation program in your area.
The FDA has approved seven medications, including nicotine-replacement therapy and nicotine-free smoking aids. Your doctor will prescribe an appropriate medication based on your medical condition and what you’ve tried before. If one method doesn’t work, you can often turn to another. And more therapies may come. Researchers are now investigating several vaccines and novel medications for smoking cessation.
Nicotine addiction has a physical, a mental and a social aspect. Research shows that pairing counseling with medication is a very effective tool for smoking cessation.
Programs are available through your county and state health departments at 800-QUITNOW, the American Lung Association, the American Cancer Society and many other organizations. Another tip: Find a quit buddy—a friend or family member who is also trying to quit or who is simply willing to offer support whenever you need it. There is often a perception that COPD is a self-inflicted disease; if you didn’t smoke, you wouldn’t have developed it. According to research, having a support system predicts success in the short term.
Even under the best circumstances, only about one in four people are successful at quitting after one year. Most people have to make the attempt more than once. Think of your previous attempts as practice quits, and try again—it’s well worth it.
Vitamin D may help delay the lung decline of COPD, according to
preliminary research presented at the American Thoracic Society’s 2009
international conference. Calcitriol, a form of vitamin D synthesized
by the human body, is an anti-inflammatory and may delay airway
remodeling, a process that gradually reduces lung function, says lead
author Gautam Damera, Ph.D., of the University of Pennsylvania.
Researchers plan to conduct further studies of calcitriol and to
determine optimal dosages. In the meantime, “talk to your physician
about taking vitamin D,” says Damera. “A supplement containing 400 to
600 IU of vitamins D2 or D3 may be beneficial.” |
Mealtime can be challenging for those with advanced COPD. In a study
published in the American Journal of Respiratory and Critical Care
Medicine, those with COPD were found to be more likely to swallow solid
food while inhaling, or to inhale accidentally while eating soft foods
such as pudding.
The possible result: Food and bacteria may be breathed into the lungs,
which can cause infection and a flare-up of symptoms. Sitting upright
while eating and switching from softer foods to harder foods—or vice
versa—may help, says Roxann Diez Gross, Ph.D., of the University of
Pittsburgh, the study’s lead author. And if you have a problem, ask for
a referral to a speech-language pathologist. “Evaluation and treatment
by a professional may help preserve lung function and improve the
quality of life,” says Diez Gross. |
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