COPD Takes Your Breath Away
Millions of us-especially women-are paying a hefty price for years of smoking.
by Jeffrey Bramnick
 You see more and more people coughing, stopping for breath after a few steps, or toting oxygen tanks. Why are they having so much trouble with something the rest of us take for granted—breathing?
The culprit is chronic obstructive pulmonary disease (COPD), Americans’ fourth leading cause of death. COPD threatens to overtake stroke as the number three killer in the next decade.
“There are 24 million people with COPD, and only half of them have been diagnosed,” says John E. Heffner, M.D., past president of the American Thoracic Society. A typical patient is age 45 or older.
COPD includes two maladies that often occur together:
- Chronic bronchitis, which causes inflammation and scarring of the lungs
- Emphysema, which damages air sacs in the lungs
Years of smoking cause 85 to 90 percent of COPD. Some smokers are more prone to COPD than others, but the reason is unclear. The cause of the other 10 to 15 percent of COPD is also unclear.
A Costly Problem
COPD cost the U.S. $42.6 billion in 2007, including $26.7 billion in direct health care costs.
—National Heart, Lung, and Blood Institute
One thing is clear. The main reason for COPD’s growth is that women have caught up to men. Smoking—and COPD—were once more common among men. But today’s women are paying the price for their increased smoking after World War II. “More women smoking means more COPD,” Dr. Heffner says. In 2006, 2.9 million men and 6.6 million women were diagnosed with COPD, the American Lung Association says.
“Traditionally, COPD was thought of as a lung disease only,” Dr. Heffner says. “Now we are seeing it more as a systemic inflammatory disease in which the lungs are the portal of entry. People with COPD very often have other health problems, such as heart disease, lung cancer, sleep apnea.”
COPD can’t be cured. Strides are being made in treatment, which usually consists of using one or more inhalers. “People with COPD should be sure to be vaccinated against the flu and also against pneumonia,” says Dr. Heffner. COPD patients face a high risk of complications if they get these ailments.
The best prevention? Avoid smoking and secondhand smoke, Dr. Heffner says. He believes that anyone who smokes should be screened. “Early diagnosis and treatment is best,” he adds.
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