Rates of serious lung conditions like COPD are trickling upward—despite the fact that fewer people are smoking. To be exact, the rate of adults who smoke cigarettes has declined from about 21 percent in 2005 to 14 percent in 2017, according to the Centers for Disease Control and Prevention.
Unfortunately, Americans are still dealing with the consequences of the previously high rates of smoking. Since many people in the late 20th century smoked cigarettes, and COPD takes decades to develop, we're just now seeing COPD symptoms in those long-term smokers.
What Is COPD?
Chronic obstructive pulmonary disease, better known as COPD, is a lung condition that causes shortness of breath. It includes chronic bronchitis and emphysema, but since many patients exhibit symptoms of both, doctors more commonly refer to it all as COPD.
COPD means that the airways (or bronchial tubes) of the lungs are inflamed and thickened. The inflammation in the bronchial tubes narrows the air passages, thus leading to the "obstruction" in the COPD name. Additionally, the tissue in these airways is supposed to exchange oxygen as you breathe, so when it’s damaged from inflammation, the body receives less oxygen, according to American Lung Association (ALA).
To make it worse, the inflamed lung tissue also has a harder time expelling carbon dioxide. The brain recognizes this imbalance between oxygen and carbon dioxide, and it signals to the lungs to work harder. As a result, breathing becomes faster, deeper, and more labored in an attempt to get enough oxygen.
Risk Factors for COPD
The vast majority of COPD cases—about 80 percent—are linked to smoking. However, not all people who get COPD are smokers. Here are all the risk factors of COPD, according to the ALA:
Smoking: Smoke in the lungs inherently invites inflammation, so the immune system has to deploy white blood cells to the area, according to the COPD Foundation. This inflammation destroys lung tissue over time.
Air pollution: Over 40 percent of Americans reside in counties with poor air quality, according to the ALA. “Particle pollution” refers to the tiny particles in the air that you inhale; these particles can get into the lungs and even the bloodstream and have an effect on your health.
Secondhand smoke: Being exposed to secondhand smoke in childhood can harm lung health as you age.
Working with chemicals, dust, and fumes: Workers exposed to particle pollution on a daily basis (such as miners exposed to coal mine dust and farmers exposed to grain dust) count for about 15 percent of COPD cases. These are frequently referred to as “work-related COPD.”
A genetic condition called Alpha-1 deficiency: This hereditary condition is commonly referred to as “genetic COPD.” Not everyone with Alpha-1 deficiency experiences symptoms of a lung disease.
And a history of childhood respiratory infection: A 2015 study in Respiratory Research found that pneumonia during childhood increases the risk of COPD, as well as decreased lung function in general.
The good news is that COPD rates should start falling if smoking rates continue to decline (although current use of e-cigarettes in teens could threaten this). It’s important to remember that people developing COPD now likely started smoking during a time when the health risks of smoking were less known. Keeping tobacco use low (and curbing air pollution) can help bring COPD rates back down for future generations.