What is emphysema?

What is emphysema?

Joined: 18 Dec 2008, 23:57

11 Nov 2000, 03:31 #1

The following article is from the ALA's web site at the below link and is an excellent basic primer on emphysema. I know that some of our members do have breathing disorders and maybe they shed a bit more light on this important topic. Maybe Joel or one of you can help answer my pretty basic questions. As stated below, emphysema results from the destruction of our alveoloi. The explanations that I keep reading, including this one, make it sound like that except for an extremely small portion of victims who may inherit a specific gene, that the damage to our alveoloi is caused by external substances that enter the lung and eventually lead to permanent damage. My questions are: (1) Is emphysema a true disease in the traditional sense; and, (2) although the alveoli once damaged can't repair themselves, does additional harm and damage immediately cease once we quit smoking? Thanks, Zep

From the American Lung Association
What Is Emphysema?Emphysema is a condition in which there is over-inflation of structures in the lungs known as alveoli or air sacs. This over-inflation results from a breakdown of the walls of the alveoli, which causes a decrease in respiratory function (the way the lungs work) and often, breathlessness. Early symptoms of emphysema include shortness of breath and cough.

How Serious Is Emphysema?Emphysema is a widespread disease of the lungs. In 1993, 1.9 million people in the U.S. had emphysema.

It is estimated that 50,000 to 100,000 Americans living today were born with a deficiency of a protein known as alpha 1-antitrypsin (AAT) which can lead to an inherited form of emphysema.

Emphysema ranks 15th among chronic conditions that contribute to activity limitations: over 43 percent of individuals with emphysema report that their daily activities have been limited by the disease.

Many of the people with emphysema are older men, but the condition is increasing among women. Males with emphysema outnumber females by 22 percent.

Causes Of EmphysemaThe lung has a system of elastic fibers. The fibers allow the lungs to expand and contract. It is known from scientific research that the normal lung has a remarkable balance between two classes of chemicals with opposing action.

When the chemical balance is altered, the lungs lose the ability to protect themselves against the destruction of these elastic fibers. This is what happens in emphysema.

There are a number of reasons this chemical imbalance occurs. Smoking is responsible for 82 percent of chronic lung disease, including emphysema. Exposure to air pollution is one suspected cause. Irritating fumes and dusts on the job also are thought to be a factor.

A small number of people with emphysema have a rare inherited form of the disease called alpha 1-antitrypsin (AAT) deficiency-related emphysema, or early onset emphysema. This form of disease is caused by an inherited lack of a protective protein called alpha 1-antitrypsin (AAT).

How Does Emphysema Develop?Emphysema begins with the destruction of air sacs (alveoli) in the lungs where oxygen from the air is exchanged for carbon dioxide in the blood. The walls of the air sacs are thin and fragile. Damage to the air sacs is irreversible and results in permanent "holes" in the tissues of the lower lungs.

As air sacs are destroyed, the lungs are able to transfer less and less oxygen to the bloodstream, causing shortness of breath. The lungs also lose their elasticity. The patient experiences great difficulty exhaling.

Emphysema doesn't develop suddenly, it comes on very gradually. Years of exposure to the irritation of cigarette smoke usually precede the development of emphysema.

A person may initially visit the doctor because he or she has begun to feel short of breath during activity or exercise. As the disease progresses, a brief walk can be enough to bring on difficulty in breathing. Some people may have had chronic bronchitis before developing emphysema.

Treatment For Emphysema Doctors can help persons with emphysema live more comfortably with their disease. The goal of treatment is to provide relief of symptoms and prevent progression of the disease with a minimum of side effects. The doctor's advice and treatment may include:

Quitting smoking: the single most important factor for maintaining healthy lungs. Bronchodilator drugs (prescription drugs that relax and open air passages in the lungs): may be prescribed to treat emphysema if there is a tendency toward airway constriction or tightening. These drugs may be inhaled as aerosol sprays or taken orally. Antibiotics: if you have a bacterial infection, such as pneumococcal pneumonia. Exercise: including breathing exercises to strengthen the muscles used in breathing as part of a pulmonary* rehabilitation program to condition the rest of the body.
*The term "pulmonary" refers to the lungs.
Treatment: with Alpha 1-Proteinase Inhibitor (A1PI) only if a person has AAT deficiency-related emphysema. A1PI is not recommended for those who develop emphysema as a result of cigarette smoking or other environmental factors. Lung transplantation: most recent reports have been encouraging and the success rate continues to increase. Lung reduction surgery: this new technique shows promise. Experience at this time is limited. Emphysema ResearchContinuing research is being done to find answers to many questions about emphysema, especially about the best ways to prevent the disease.

Researchers know that quitting smoking can prevent the occurrence and decrease the progression of emphysema. Other environmental controls can also help prevent the disease.

If an individual has emphysema, the doctor will work hard to prevent the disease from getting worse by keeping the patient healthy and clear of any infection. The patient can participate in this prevention effort by following these general health guidelines:

Emphysema is a serious disease. It damages your lungs, and it can damage your heart. See your doctor at the first sign of symptoms. DON'T SMOKE. A majority of those who get emphysema are smokers. Continued smoking makes emphysema worse, especially for those who have AAT deficiency, the inherited form of emphysema. Maintain overall good health habits, which include proper nutrition, adequate sleep, and regular exercise to build up your stamina and resistance to infections. Reduce your exposure to air pollution, which may aggravate symptoms of emphysema. Refer to radio or television weather reports or your local newspaper for information about air quality. On days when the ozone (smog) level is unhealthy, restrict your activity to early morning or evening. When pollution levels are dangerous, remain indoors and stay as comfortable as possible. Consult your doctor at the start of any cold or respiratory infection because infection can make your emphysema symptoms worse. Ask about getting vaccinated against influenza and pneumococcal pneumonia. COPD: A Growing ProblemChronic obstructive pulmonary disease (COPD), a term that generally applies to chronic bronchitis and/or emphysema, has increased by a dramatic 57 percent between 1982 and 1993.

Today, chronic bronchitis and emphysema combined constitute the most common chronic lung disease, affecting 15.8 million people in the U.S.

The number of lives claimed by chronic lung disease has increased sharply, too. In 1979, it accounted for about 50,000 deaths. In 1982, the number rose to 59,000 and by 1992, the number of deaths reached 86,974.
Last edited by John (Gold) on 26 Mar 2009, 21:50, edited 1 time in total.

Joined: 18 Dec 2008, 23:57

11 May 2001, 03:22 #2

Last edited by John (Gold) on 26 Mar 2009, 21:51, edited 1 time in total.

Joined: 07 Jan 2009, 18:59

11 May 2001, 03:39 #3

Zep thanks. Good to read more. Spending some time cruising around here to keep reading. The Tiggers Article was good, and the one on medical issues regarding lungs. Lots here, especially all those awful pictures. Can't answer either of you questions ... would be interesting to ask my doctor. I'm pretty sure it takes some months for them to heal. Actually, this IS what my Dr. told me on Monday, because I was having trouble with my lungs (lots more than usual). He said to be patient. It would take a few months. Whew. And the pictures on the ciggerettes packs (alot of them) have been out here in Ontario, Canada. Consiously, I don't think they made much of an impact on me ... and most serious smokers that I know... until I/we get sick. The "It won't happen to me sydrome. Thanks
sunshineray 14th and counting again.

Joined: 18 Dec 2008, 23:59

11 May 2001, 05:52 #4

Thanks again Zep for the information You have sure worked hard to provide us with the best education and information about smoking as possible. About your questions...I think it's a language barrier, because I can't quite understand what you mean by the first question "Is emphysema a true disease in the traditional sense". Could I interpret it like this "Would there be emphysema if there wouldn't be smoking in the world? (without counting the hereditary form of it)". I find the second question very interesting, too.

I have been Quit for: 2M 2W 5D 23h 51m 22s. I have NOT smoked 1619, for a savings of $111.37. Life Saved: 5D 14h 55m.

Joined: 18 Dec 2008, 23:57

11 May 2001, 09:22 #5

I guess I didn't make that question very clear or maybe only my mind sees disease in such a light but let me try again. In my mind a disease is something that continues to spread once you develop it. Sort of like a cancer. Sometimes medicine uses the word disease in situations where the condition doesn't spread at all. For example, you may at some point in your life hear the phrase "degenerative disc disease" in reference to the spine. It sounds pretty bad and I've seen it scare lots of folks with back problems. In reality it's nothing more than the discs in our spine losing their moisture and drying out as we age. Just like most of us experience more skin wrinkles as we age and gradually seeing our hair thin, it's a natural part of the aging process for most of us - yet it is still called a disease.

With emphysema, my question about it really being a disease is along the same lines. Although just like our spine our lungs certainly age with time, if we quit smoking and quit putting other harmful things into our lungs does the progression of the disease stop or slow tremendously, or is it more like a cancer that continues to spread? From what I've read (since first posting this article) I now believe that the damage is never correctable but, aside from normal aging, that quitting really does help almost stop further damage. Anyway, that's what I want to think I guess we all do!

Joined: 19 Dec 2008, 00:00

11 May 2001, 10:16 #6

Zep, being a nurse who works with the elderly patients, a lot of them with COPD which includes emphysema and asthma, who continually need respiratory treatments. I see respiratory techs all the time...and after I was told that I had beginning emphysema, I have questioned all of the techs...this is what they tell me in short... the parts of the lungs that are dead will never recover...but the tissue in the lungs that is a sleep, (meaning coated) will wake up when the damaging sorce is stopped being put into the lungs....this is not a progressive disease unless you continue to put into the lungs the sorce that is doing the damage...sorces include smoking, chemicals, etc.....

And after seeing so many of those patients struggle for something that we all take for granted (a breath) you would think that I should have been able to quit smoking long ago...that is how powerful addicting nicotine is...
Patients tell me that their breathing is like breathing with a pillow over their face all the time...try that out..put a pillow over your face and breath....difficult...and they breath like that all the time...they also have times when they are in a crisis...like humidity increases, catching a cold.....man or man how these patients STRUGGLE for their next breath...

Joined: 19 Dec 2008, 00:29

15 Aug 2001, 11:02 #7

Thanks Zep and Joel... Mitch here. Twas I who asked to learn more about emphysema. Since I quit over 3 months ago, I've had bronchial asthma (had that when I was a kid), hay fever and recently a shortness of breath. I attribute it all to...smoking had masked these symptoms.

But... I find that I'm stressed out lately and hoving hyper tension...you know...hyperventilating...not being able to get enought oxygen...then it goes away...poof...everythings fine.

After reading and talking to others, I was a little paranoid about the possibility of having emphysema. It's just that the quit had made my lungs, smell and attention so acute...every little thing is noticed.

I'm fine...nothing like a little flyfishing to relieve the stress. I'm breathing like a champ today, deep breaths...no worries.

One thing that's really came home to me is that breath is the connection to life. How fragile it is. I'm really loving breathing lately.

Thanks yall for everything. I'm 4 months into my quit. Mitch

Joined: 18 Dec 2008, 23:57

15 Aug 2001, 19:51 #8

As you've already know, Mitch, the most important thing is that you've stopped the destruction of healthy lung tissue. My mother had emphysema and spent the last year and a half of her life on oxygen, my younger sister Pat (who started smoking at age 12) has it, and yes, even I was told that I had very eary signs, as well. I'd had pneumonia for two Januarys in a row, my cough, constant throat clearing and wheezing sounds were chronic, and still I sucked down three packs a day. Two years + later, I feel great! I have more energy then I've had in years! The noises are all gone too! I have not had a single breathing illness, flu or cold either!

Oh, I'm not kidding myself! I know that later in life I'll probably pay a price but I know I've lowered it bit by quitting now, and so have you! Mitch, I found this article on emphysema surgery, that was published yesterday, which only makes this new life we've gifted to ourselves all the more important.

Enjoy the fishing and listen to your doctors! I hope you're feeling better soon. YQB Zep : )

Study: Emphysema Surgery DangerousBy Jeff Donn
[/size]Associated Press Writer
[/size]Tuesday, Aug. 14, 2001; 6:42 p.m. EDT[/size]BOSTON -- An increasingly common operation for emphysema that involves cutting away part of the lungs is dangerous - and even deadly - for many patients in advanced stages of the disease, researchers say. Sixteen percent of the very ill patients who had the surgery were dead within a month, according to the latest findings from an ongoing national study of the procedure coordinated by the National Institutes of Health.

Those who survived showed limited benefit from the procedure.

Researchers immediately halted more surgery on patients with the same characteristics of advanced illness. They are now confining their testing to more than 1,000 other emphysema patients because the surgery may still help them.

The investigators will publish the findings Oct. 11 in The New England Journal of Medicine but released them Tuesday to alert doctors and patients immediately. The disease, which is tied largely to smoking, strikes about 2 million Americans each year.

The surgery has stirred much excitement over the last five years, and some studies have suggested it can give at least a reprieve to many patients.

"There has been a prevailing view - that I think unfortunately surgeons have contributed to - that this operation may be a temporary cure for your disease, and it's clear that it's not for this subset of patients," said one of the researchers, Dr. Steven Piantadosi of Johns Hopkins University.

A pioneer in the surgery, Dr. Joel Cooper, downplayed the findings. He said they were predictable because patients reported in the latest findings suffered from disease that was widely spread around their lungs. He said they were bad candidates for the surgery in the first place.

Cooper said his team dropped out of the five-year study in 1997 over this and other disagreements, including a condition that all participating surgeons stop doing the surgery outside the study.

He also said administrators at the federal Medicare program for the elderly, which is funding the study, are seeking justification to limit, delay or deny coverage for the surgery, which typically costs from $25,000 to $40,000.

"Medicare has used the trial for its own purposes," said Cooper, a lung surgeon at Washington University in St. Louis.

An official at the Centers for Medicare and Medicaid Services said the agency didn't interfere with the scientific decision-making. The official spoke on condition of anonymity, which is agency policy.

Dr. Gail Weinmann, project officer for the study at the National Institutes of Health's Heart, Lung and Blood Institute, said surgeons agreed to forgo surgery outside the study because they saw a need for systematic research.

"There was a concern about the spread of the procedure so quickly, and that it could be doing harm," she said.

The surgery was first tried more than 30 years ago with disastrous results. Improvements in anesthesia, surgical methods and postoperative care revived it in the 1990s. It is based on the idea that smaller, but healthier lungs can work better after the operation.

The technique became so widespread in recent years, with around 8,000 operations now performed, that researchers had trouble finding patients for the study. They said some candidates feared they would be assigned to comparison groups taking normal treatment, which includes diet, exercise and drugs.

In the latest findings, though, none of the 70 patients in the normal treatment group died within a month. The surgery left 11 of 69 patients dead.

Over three years, surgery patients were four times more likely to die than the others. Also, surgery survivors gained only limited benefit in better breathing or quality of life.

Weinmann defended the decision to operate on patients included in the latest findings, saying they were an important group to study and there is little medicine can do for them.

Lung specialists outside the study said patients with broadly spread disease were suspected to be relatively poor candidates for the surgery. However, they said the findings are valuable because they underscore the potential danger for some patients who may be overly eager for the surgery.

"In these patients ... someone needs to have a serious talk with them," said Dr. Jeffrey Drazen, a lung specialist who is also editor-in-chief of the journal.

"My guess is that most physicians will heed this warning," added Dr. Norman Edelman, scientific consultant for the American Lung Association.

Joined: 07 Jan 2009, 19:34

15 Aug 2001, 21:41 #9

Hello Joel, Zep and everyone..

Here is a link I found concerning copd and emphysema.


btw, I am doing ok, but this disease is a killer for sure. I have gotten to the point I have trouble breathing when we travel to large cities with a bad smog level. People really need to understand how horrid it is. Slow suffocation is all it is... and its terrible.

Six months, two weeks, five days, 8 hours, 41 minutes and 12 seconds. 12021 cigarettes not smoked, saving $1,442.30. Life saved: 5 weeks, 6 days, 17 hours, 45 minutes.

Joined: 19 Dec 2008, 00:29

16 Aug 2001, 02:46 #10

Thanks yall...Mitch here. Wow...that's some nasty %$#@ emphysema. Really don't like the operation route...really glad I don't smoke anymore...AND...really glad I just have hypertension, something I can do something about.

The definition of hypertension...picture a cat in a room full of rocking chairs during an earthquake. Anyway...all I needed was more rigorous exercise...and to stop worrying about imaginary things that I make up and can do nothing about anyway...no worries.

Geez Zep...3 packs a day...****...that's one smoke every 18 minutes. Boy am I glad you cancelled that habit...and thanks for the support and concern.

Yeah lungs are precious. Deep breaths are a gift...no more abuse ever again. 4 months now. I never even knew some Dahlias have a fragrance and I'm a Dahlia freak. Wow...life is awesome.

Joined: 18 Dec 2008, 23:57

02 Feb 2002, 04:29 #11

I've been visiting a few lung transplant sites on the net and I found it interesting that many require smokers to quit smoking BEFORE surgery. For example, these are the online posted transplant requirements of the University of Penn. Transplant Center -
Who is a candidate?

Joined: 18 Dec 2008, 23:57

14 Apr 2002, 01:02 #12

Probe, as you can see from this thread, emphysema is the actual destruction of individual air sacks which not only ends their use for removing carbon dixoide from the body but also for taking in new oxygen. Congratuations on four days of awesome healing! Baby steps to glory! John

Joined: 18 Dec 2008, 23:57

01 Jul 2002, 09:48 #13

Stuart, as I believe this thread indicates, emphysema is primarily an environmental disease and not one that spreads like an infection or cancer. You've stopped inflicting damage by destroying additional alveoli from smoking. If concerned you can see a pulmonologist and not only get all your questions answered but also get a second opinion.

I too have been told I have early emphysema. I try to remember to wear a mask when digging in dirt (gardening) or mowing the grass. I can run like wind for the first time since I was 15, Stuart. What's done is done. By quitting we've turned off the burner. We've put our lungs in a condition where they'll age naturally, from their current state, from here on out. It's the best thing we could have done.

Joined: 19 Dec 2008, 00:29

13 Nov 2002, 13:08 #14

It was my doctor telling me I have emphysema that finally got me off my butt and quitting. My paternal grandfather died of E in his early fifties. My dad was scared to death that he had E and would die like his dad did, and quit when he was 35.

It was rather cold the way they told me I had it. After a yearly physical including blood work and chest X-rays the doc's nurse calls me up a few days later. "your cholesterol is high. your red blood cell count is high - thats from smoking. your liver enzymes are good. Oh, and by the way, the radiologist reading your Xrays has determined you have emphysema."

Well. From the way the message was delivered one would think "Ah, no big deal. Hemmoroihds, tonsillitis." Well, no. A bit of research on the web brings up word like irreversible, progressive, and fatal.

So I called my doc back and said "Tell me about this diagnosis" He says "It's really no surprise, given that you've smoked 2 packs a day for 30 years." I say "What now ?" He says "Well, you can keep smoking and in 5-8 years you'll be on oxygen 24-7, or you can quit now and it won't get any worse."

I'm not in that bad shape now. I can charge around our oversized block, with fairly significant hills, with my wife who has never smoked and not be any more out of breath than she is.

We had an extended damp period a week or so ago, and I noticed the slightest shortness of breath at rest then. That scared the ****** out of me. The weather dried out and things returned to normal.

Last week I had an appointment and "bragged" to my doc that I had quit for six weeks and was planning on staying that way forever and what could I/he/we do to keep the E from getting worse ? So he gave me Advair, which is a combination bronchodialator and steroid in inhalable powder form. My research on the web indicates that it is typically prescribed for asthma sufferers, but it can certainly help with E as well.

So far, so good. As the weather has stayed dry since getting the script I can't say for sure that the advair is for sure the thing that is doing the trick, but it has been better.

What I've found from researching E on the web : Bottom line : if you live long enough you will get emphysema. It's part of the natural deterioration of the body with age.

Smoking causes onset at a much earlier age. Much earlier. And once you have onset continued smoking accelerates the progress.

If you have onset and quit, it is my understanding that progress of the disease continues from there at the normal aging rate. That's what my doc tells me, and that's what I'm banking on.

Joined: 18 Dec 2008, 23:57

25 Nov 2002, 11:51 #15


Joined: 07 Jan 2009, 20:16

26 Nov 2002, 07:46 #16

This is part of message number 9 pasted. I have a question that I hope somebody can answer for me. I spent quite a bit of time last night cruusing the internet looking for more information on COPD. I didn't find anything that specifically addresses this part. And I do admit I did get a bit sidetracked looking at other aspects. The part I am curious about is the part I bolded. Does this mean that with emphysema you can get more lung function back?

Thank you for any answers.

"Zep, being a nurse who works with the elderly patients, a lot of them with COPD which includes emphysema and asthma, who continually need respiratory treatments. I see respiratory techs all the time...and after I was told that I had beginning emphysema, I have questioned all of the techs...this is what they tell me in short... the parts of the lungs that are dead will never recover...but the tissue in the lungs that is a sleep, (meaning coated) will wake up when the damaging sorce is stopped being put into the lungs....this is not a progressive disease unless you continue to put into the lungs the sorce that is doing the damage...sorces include smoking, chemicals, etc....."

Joined: 18 Dec 2008, 23:57

26 Nov 2002, 22:40 #17

Hello Anastazia:
The underlying lung tissue which is destroyed cannot regenerate. In a sense then, the loss of lung elasticity cannot come back. But the lining tissue of the wind pipe does regenerate. This tissue, primarily the Cilia is key to sweeping out the lungs, keeping the airways open and making breathing easier. So by this tissue being repaired, even though you don't get back the lungs elasticity, it keeps the airways cleaner and makes it easier for the remaining lung tissue to work without small airway obstructions. Added to this is the bonus of the blood's ability to carry much larger amounts of oxygen than when poisoned by carbon monoxide from tobacco smoke. Again, the lungs as well as the heart's workload is decreased when the blood carries the extra oxygen.
Last edited by Joel on 26 Mar 2009, 21:57, edited 1 time in total.

Joined: 18 Dec 2008, 23:57

27 Nov 2002, 01:46 #18

Anastazia, I saw this post yesterday and spent a bit of time before bed exploring the question you raised in the highlighted portion. I think you have the same question that I've had all along with the subject of emphysema. As Joel says, clearly those alveoli (air sacs), among that 300 million that we started with in each lung, that have been destroyed will remain destroyed. But, in talking about emphysema being a "progressive" disease, does it remain progressive even after we quit smoking?

Although you'll find some research in the area of regeneration, I don't think you'll find any info at those sites suggesting that there is any hope of ever regenerating any dead alveolus - the research appears aimed at generating (growing) new alveoli.

As for the progressive nature of the disease, most literature I've been able to locate makes statements like this -
"Those patients who smoke should stop smoking immediately; this is the most important step patients can take to stabilize their disease and guard against further lung damage." http://medicine.creighton.edu/forpatien ... ysema.html

"The emphysematous patient must stop smoking to retard progression of the disease." http://www.lung.ca/diseases/emphysema.html
This is the portion of the above post you highlighted ..."but the tissue in the lungs that is a sleep, (meaning coated) will wake up when the damaging source is stopped being put into the lungs...."

Anastazia, I have yet to read anything contrary to above statement and much of Joel's wonderful post about the beauty of cilia healing I'm sure applies to all still living cells coated knee-deep beneath any chemical build-up.

What I would like to think is that because I stopped pumping the 4,000+ chemicals delivered into my lungs with each puff, that my emphysema will never ever grow any worse than it is right now, so long as I never take another puff. I wish it was true. Clearly I've brought an abrupt halt to smoking's intentional destruction of my remaining capacities but those remaining capacities are still subject to both the normal aging process, other environmental agents aside from cigarette smoke, and any genetic susceptibilities to emphysema that my deceased mother (advanced emphysema), my sister (moderate) and I (light) have already demonstrated exist in our family.

Will quitting smoking help substantially increase overall lung function for every person with emphysema? I'd love to hear an emphysema expert's answer to that question as it would seem to me that to one degree or another the elasticity and performance of every still living alveolus must be enhanced by not having to fight the 3,500+ particles and 500+ gases arriving with each puff. I can't speak for everyone but I can for my sister and I and in our cases we've noticed tremendous improvement in both breathing capacities and endurance. John

Joined: 18 Dec 2008, 23:57

27 Nov 2002, 23:04 #19

Yesterday I emailed a friend at the American Lung Assocation posing the following two questions. The response I just received follows:
How much does quitting smoking halt the progression of the disease?

Does every person with emphysema experience an overall increase in their remaining lung function capacities when quitting?
John - this was from the pathologist. One thing to add into the mix is the
degeneration due to ageing.

> In most cases, the progression of the disease stops when the smoking
> stops. In the rest of the cases, it usually slows down. However, there
> is no repair of the lung that has dissolved.
> Large and small airways diseases are also caused by smoking and
> contribute to the symptoms. Much of this is reversible. Cough and
> phlegm usually intensify for a few days to a few weeks, then get better
> and go away. Along with this, the larger airways open up some and
> airflow gets better. There's a lot of variation from person to
> person.

Joined: 18 Dec 2008, 23:58

02 Feb 2003, 05:32 #20

Added the following after noticing the use of bronchodilators for the treatment of emphysema above. My question, would it be reasonable to expect that symptoms of emphysema could be masked by the bronchodilators in cigarette smoke?... would it also, then, be reasonable to conclude that the symptoms of emphysema could seem worse after quitting, due to the lack of those bronchodilators?

Not looking for medical advice, of course, but I think it's a worthy discussion issue given the potential for someone to blame their quit for a worsening of their pulmonary function.

From: GrumpyOMrsS (Gold) Sent: 3/2/2002 6:10 AM
just a note to John concerning the additives in your vantange cigarettes and all other brands as well.....the first two you mentioned, licorice and cocoa are the vehicles put in the cigarettes not only to enhance the taste and smell, but they are actually the bronchodialors in cigarettes. those are the two ingredients added to cigarettes to make sure that our bronchii are open and able to accept the nicotine for faster delivery to the brain. Cocoa contains theopholine, the chemical used in inhalers for asmatatics and others suffering from COPD, as well as the licorice which contains, Glycyrrhizin. This explains in part why many people reach for chocolate or black licorice after quitting smoking. By the way, besides many calories for both chocolate and licorice, the glycyrrhizin in licorice, if ingested in larger than normal quatities, has the ability to raise one's blood pressure according to my pulmonologist. So this must be watched too.

below the findings in the tobacco hearings:

3.4.3 Cocoa and theobromine
Widely used as an additive, cocoa contains alkaloids, which may modify the effects of nicotine and have a pharmacological effect in themselves. Cocoa also contains about 1% theobromine, a 'bronchodilator' - encouraging expansion of the airways and facilitating increased smoke and nicotine intake.
The following quotes are from scientific and medical papers held by Philip Morris:

"Theobromine: The principal alkaloid of the cocoa bean which contains 1.5-3% of the base... bronchodilation effect in asthma."51
"The bronchodilator effect of a 10mg dose of theobromine was compared with that of 5mg of theophylline in young patients with asthma.... In this single dose study the bronchodilatory effect produced by theobromine was clinically and statistically significant.... improvement in all pulmonary function tests was noted after the ingestion of theobromine or theophylline."52 The addiction of these chemicals, in many cases, may mask an underlying problem when smoking. Stop smoking and take away these additives and a person who does not know he has asthma or emphsema or other symptoms of COPD is at once faced with a difficulty breathing from lack of broncodiators. This is how I found out I had asthma. Of course keep on smoking and you're liable to end up with much, much worse.

3.4.4 Glycyrrhizin
An ingredient of liquorice - another commonly used additive, glycyrrhizin also acts as a bronchodilator.
"What does a bronchodilator do? The bronchodilator makes it easier for you to inhale, so obviously if you are having difficulty putting smoke in your lungs, it's good to have a bronchodilator in there. Now I was asked recently whether I knew whether the glycerizon being delivered is delivered in adequate concentration to cause that to happen. I do not know the answer to that question. It would be interesting to know whether that has been studied by the industry. If they have studied it, it would seem that that is the kind of information that should be shared with regard to ingredients. The point is, however, that we know it can happen, it is a bronchodilator. The probability that it happens is very high, but that would be related to studies that should be done."53 (Farone WA 1997)


2 years free

Joined: 18 Dec 2008, 23:59

07 Mar 2003, 22:52 #21

Thanks for bringing up this thread, Joanne. I had never read it because I didn't think it applied to my life. Unfortunately I think we are all affected one way or another by smoking-related conditions.

There is a very dear, sweet lady whose office is next door to mine, and she was a heavy smoker for over 30 years. She has emphysema, asthma and chronic bronchitis, yet she continued to smoke until about a month before I quit. She quietly quit (didn't tell a soul until people started noticing) with a nicotine patch and was still on it for about a month after I had quit. Once she withdrew from the patch she was OK and seemed to understand the concept of the Law of Addiction. I guess I just assumed she was listening to me talk about Freedom, since we had something in common. It was wonderful not to hear that constant racking, phlegm-y cough and I often asked her how she was feeling since she'd quit, and she'd answer that she hadn't felt this good in years.

However, over the last few weeks I've caught her smoking twice (she doesn't know this). I printed out a few articles and left them around where she'd see them, and found them in the trash. Now, that horrible cough is back, and she's back to calling in sick once or twice a week. Sometimes she's just too weak to get in her car and drive to work. It breaks my heart that she's relapsed, that she's killing herself again. As I type this I can hear her struggling to breathe. I don't guess there's much else I can do, but it sure felt good to get this off my chest. Thanks for listening.


9 months, 1 week, 1 day

Joined: 19 Dec 2008, 00:06

04 Feb 2006, 09:44 #22

My dad suffered from this disease for 20 years before he was diagnosed with lung cancer and 14 months later died from that. I am not afraid of picking up a nicotine delivery device again and DYING.....I'm afraid that I'd pick it up and live the way he did for 20 years. His whole life was compromised by the disease. And still he smoked until 4 days before he died. If that isn't addiction, I don't know what is! And sadly, I smoked with him and continued for 10 years after he died.

I am now quit for 28 days (and the rest of my life, one day at a time) and my sister is quit for 8 days. I think my dad has interferred with our lifes and, somehow, gave us the insight to be able to break this chain. I am 58, my sister 50 and it's taken us this long to get the message!! But got it we did and we are on our way to living happy, joyous and free of any substance. All we have to do is NTAP!!!

sandy -a nicotine addict who hasn't used nicotine for Twenty Eight Days, 23 Hours and 15 Minutes, while extending my life expectancy 1 Day and 12 Hours, by avoiding the use of 435 nicotine delivery devices that would have cost me $65.26.

Joined: 19 Dec 2008, 00:06

17 Apr 2006, 23:58 #23

I have a brilliant friend -- a writer, actor, and teacher -- who is maybe 62 years old, and I find myself avoiding her because it is soo painful to be in her house, where it's so hard to breathe through all the cigarette smoke, and then, through a cloud of smoke, watch her labored breathing. A couple of years ago, I took a walk with her and was stunned with fear and sadness at how much lung capacity she was losing to emphysema. Thank you for bringing this thread back, Sal.
I thank my lungs every day for supporting my life, and now, I can only hope that all of us have quit in time.

best, joanne, free for 97 days

Joined: 18 Dec 2008, 23:57

21 Jul 2006, 09:28 #24

My dad smoked filterless cigs or roll your own for nearly 60 years. After hauling him and his oxygen tank around to doctor appointments today....this one seemed like a good one to bring up.
6 months +

Joined: 18 Dec 2008, 23:57

22 Aug 2006, 09:01 #25

A point of clarification: I read today in a journal that COPD is an easier way of saying Emphysema.

Emphysema is but one of the forms of COPD. There are several different and very distinct diseases (contracted usually by extended direct use exposure to tobacco smoke) that are grouped under the term COPD. It is important that what we all post here be factually correct.

JoeJ Free - GoldClub