Tobacco smoke contains over 4,000 different chemicals, many of which can cause damage to the lungs. These chemicals are made up of two main components: tiny solid pieces that contain tar, and the gas that contains carbon monoxide (CO) and nitrogen oxides. Smoking takes these poisonous substances directly into the lungs.
Tar in tobacco smoke damages cells in the airways, this damage can cause cells to rapidly and uncontrollably grow which can lead to cancer. The body's response to this is to send protecting cells (phagocytes) to the lungs to try and protect them but tobacco smoke destroys them. The dead cells then release substances into the structure of the lung. This leads to COPD.
Helping your patient to stop smoking will slow their lung function decline and improve their prognosis.
All current smokers should be offered help and support to stop smoking and where necessary should be referred to the Dudley Stop Smoking Service.
This illustrates the risks of smoking on lung function: differences between the lines represent effects that smoking, and stopping smoking, can have on the FEV1 of a man who is liable to develop chronic obstructive pulmonary disease (COPD) if he smokes.1
FEV1 declines continuously and smoothly over an individual’s life but in most non-smokers and some smokers clinically significant airflow obstruction never develops.1
In susceptible people, however, smoking causes irreversible obstructive changes in the lungs.1
Although the damage caused to the lungs by years of smoking is permanent, quitting smoking prevents it from worsening.1
Consequently, the accelerated decline in lung function in smokers is halted when they stop, returning to the slower rates of decline that occur naturally with ageing.1
In smokers with established COPD, stopping smoking can improve lung function by about 5% within a few months.1
Smoking cessation in patients with COPD has also been found to reduce respiratory symptoms such as cough, phlegm, wheezing and dyspnoea.2