The Effects of Smoking on the Lungs: Emphysema

By Tim Ferenchick

In 2008, singer Amy Winehouse revealed that she had been diagnosed with an early stage of emphysema at the age of 24. Model Christy Turlington was diagnosed with early emphysema in 2000 at the age of 31.

Both were smokers.

Many people believe that emphysema is a disease that only affects older people who smoke. Certainly, most symptomatic cases of emphysema are in older people, however the damage that eventually leads to symptomatic lung disease begins soon after starting smoking.

What is Emphysema? Emphysema, along with chronic bronchitis, is a type of chronic obstructive pulmonary disease (COPD).

To understand what is going wrong with the lungs in emphysema, it is helpful to understand how the lungs normally work.

Your lungs are made up of thousands of tiny little air sacs called alveoli.

When your lungs expand as you breathe in, these alveoli expand like tiny little latex balloons. Oxygen from the air passes through the walls of the alveoli and into the bloodstream.

Your diaphragm muscle contracts to expand the chest when you breathe in pulling air into the lungs, but when you breathe out, the natural elasticity of the lungs automatically push the air out of the alveoli without any muscular effort.

Think of a blown-up balloon. When you let go of it, all the air is expelled from it rather quickly and automatically due to the elasticity of the latex in the balloon.

In people with emphysema, the elastic tissue surrounding the alveoli is damaged, generally by cigarette smoke. The lungs are no longer able to expel the air automatically, and air gets "trapped" in the lungs.

Think of a balloon that has been blown up too many times. It's flabby and doesn't completely deflate when you let it go. This is essentially what the lungs of a person with emphysema are like.

People with emphysema tend to be "barrel chested" because they cannot breathe out as much air from their lungs as normal people.

Sometimes these enlarged alveoli will combine together to form larger sacs called blebs. These blebs can rupture, leading to much pain and sometimes a dangerous condition called a pneumothorax.

Emphysema also makes breathing difficult in another way. The damaged lining of the alveoli doesn't allow the oxygen to pass through to the blood stream as easily. Some people with emphysema require supplemental oxygen to keep their blood oxygen levels in the normal range.

People with emphysema often breathe out through pursed lips. This helps to apply air pressure back into the lungs while they are breathing out, inflating the alveoli more fully which allows more oxygen to pass into the bloodstream.

Treatment of Emphysema Emphysema is not reversible. Once the damage is done, there is no way to repair it, other than through lung transplant.

The goal of treatment of emphysema is to stop further progression of it and to maintain the current functioning of the lungs.

Inhalers and other medications can help to improve some of the symptoms of emphysema, but by far the most important step anyone with emphysema can take that will improve the course of the disease is to quit smoking.

Overwhelmingly, the major cause of emphysema is smoking, and without stopping smoking, the damage will continue and the disease will worsen.

The damage begins not long after you start smoking even though the effects are not seen for years. The earlier that you stop smoking, the less damage you will inflict on your lungs, and the less likely that you will develop lung disease in the future.

Dr. Tim Ferenchick is a board certified family physician who works to help smokers quit. He runs multi-session quit smoking groups in partnership with the American Lung Association. He can be reached http://www.committoquitsmoking.com

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