Smoking women and COPD

The archetype of the modern woman: clad in an executive suit and high-heeled shoes, briefcase, cellular phone on one hand and cigarette on the other.

Today, cigarette smoking has become a status symbol for the career-oriented and independent woman. It seems to give women the image of being sophisticated and glamorous. Little do they know, however, that smoking also gives them a potentially disabling disease called chronic obstructive pulmonary disease (COPD).

Such was the case of Sandra, a retired stockbroker. At first, she smoked just for the fun of it, keeping up with the modern unhealthy lifestyle of her officemates. Then she heard that smoking would help in maintaining her figure. She puffed cigarettes like a smoking chimney with the misconception that it could keep her slim. Her frenzied way of life, added to the pressures of work, made her oblivious to the known side-effects of smoking.

Sandra’s habit soon became an addition. After several years, she began to experience smoker’s cough in the morning. This slowly progressed to an all-day cough which produced small amounts of clear or whitish sputum. She also began complaining about being out of breath most of the time. As her condition became worse, she decided to consult a doctor and was diagnosed to have COPD.

COPD is a term used to describe airflow obstruction that is associated mainly with two types of lung ailments – emphysema and chronic bronchitis. It is often tagged as the "smoker’s disease" since majority of COPD patients are smokers. It is the world’s sixth leading cause of death and is predicted to become the third by 2020.

COPD decreases the lungs’ ability to take in oxygen and expel carbon dioxide. As the disease progresses, the walls of the lung’s small airways and alveoli lose their elasticity. The airway walls collapse, closing off some of the smaller air passages and narrowing larger ones. The whole airway becomes clogged with mucus. Air continues to reach the alveoli when the lungs expand during inhalation. However, it is often unable to escape during exhalation because the air passages tend to collapse during exhalation, trapping the "stale" air in the lungs.

At the recent International Conference of the American Thoracic Society (ATS), it was reported that within the next few years, more women than men will die of COPD. Historically, COPD is a respiratory illness which affects far more men than women. Times have changed though and statistics on COPD cases show an increase more in women than in men. However, despite all that is known of the devastating effect of cigarette smoking to the body, the number of smokers still continues to increase.

The data presented during the ATS conference showed a slower decrease on smoking rates in women compared to men. In 1992, 41,000 women and 51,000 men died from COPD-related illnesses. By 1997, the number of women dying from COPD rose to 53,000, whereas men’s deaths grew at a less rapid rate to 56,000. Between 1980 and 2000, the rate of death from the disease among women tripled. From 20 per 100,000, it rose to 57 per 100,000. It rose much more modestly among men, from 73 to 82 per 100,000, during that period.

In the United States, smoking is believed to account for 80 to 85 percent of COPD cases with the rest attributed to various other causes such as pollution and on-the-job dust. In developing countries such as the Philippines, the disease’s origins are somewhat broader, and include coal burned during cooking and heating.

It is critically important that COPD patients quit smoking. Once a patient has quit, the rate of decline of lung function slows considerably. Cigarette smoking is involved in many other serious health problems, including atherosclerosis, malignancies (especially lung cancer), peptic ulcer disease, ovarian failure, osteoporosis, histiocytosis-X (a disease caused by the disruption of the immune system) and other problems, like premature wrinkling. Many hospitals offer smoking cessation classes that can help.

Psychologists who studied the attitude of women toward smoking said the social pressures on women over the past decades have accounted for the slower reduction in tobacco use. Furthermore, the thin and glamorous image of smoking projected by advertisements has been a major factor in the continued use of tobacco by women. As a result, their smoking habit turns into a full-blown addiction. The thought of quitting smoking and gaining weight also adds to the reluctance of many women to quit the habit.

It is very difficult to quit smoking because it is psychologically and physically addictive. The withdrawal symptoms often experienced by people trying to quit smoking make it doubly harder. Withdrawal symptoms are caused by the withdrawal from nicotine and include depression, insomnia, irritability, anxiety, poor concentration and weight gain. Patients often gain 10 to 20 pounds after they stop smoking. An antidepressant may help reduce withdrawal symptoms and can be used alone or with nicotine replacement therapy.

COPD is an irreversible disease. The treatments that are available can only partly relieve the debilitating symptoms that come with the disease. The bout against it is made even harder since the diagnosis of COPD is frequently made when patients are in their late 50s or 60s, when the quality of life is deteriorating and the body’s ability to fight disease is declining. Quitting smoking, however, can slow down the progression of COPD. The earlier one does it, the better.

The bitter reality is that women who smoke like men will also die like men. Perhaps, a female smoker would die at an even younger age than her male counterpart since women are more prone to lung damage from tobacco than men.

The message that has to be brought across to women in particular, and to the public in general is that tobacco use poses a major health threat, no matter how classy and sophisticated it might make one look. Better old-fashioned than disabled.