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Which comes first, COPD, Emphysema, Cancer....
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Which comes first, COPD, Emphysema, Cancer....

Is there a particular order in which these conditions appear? For example, can someone get lung cancer without getting COPD first? Are there any warning signs that precede lung cancer or COPD?

I have been a pack-a-day smoker for almost 9 years now and have reduced my intake to less than half-a-pack and am tapering off even further every week.  If someone quits after a 9-year pack-a-day habit in their 20's, what's the likelihood of full reversibility of the toll a pack-a-day for nearly a decade has exacted?

And, with regard to quitting smoking, if you know, what has been the most effective supplement for kicking the habit....Wellbutrin/Zyban, the patch, Nicorette, etc., or some combination thereof?  

Thanks.
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You have made a wise decision to stop smoking!

Chronic obstructive pulmonary disease (COPD) is a general term used to describe diseases such as emphysema and chronic bronchitis.  There is no particular order in which COPD or cancer may appear.  A person may have one or the other or both conditions together.  One condition does not cause the other or make the other more likely to occur.  Cigarette smoking can cause each of these conditions.  There are no sensitive warning signs that precede either condition.

Spirometry is a simple breathing test that measures how your lungs are working.  When this is done periodically it will tell about the health of your lungs over time.  Often it will identify a problem in your lungs before you have symptoms.  If there has been permanent lung damage it cannot be reversed.  The good news is that you may have sustained little or no damage, as your exposure to the harmful effects of cigarettes has been relatively low.  About 5 years after you quit smoking your risk of lung cancer will revert almost to the level of a person who has never smoked.

Stick with your decision to quit smoking.  The most effective regimen is a combination of Zyban
6 Comments
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Avatar_n_tn
Thats an interesting question...and a very valid one at that.

COPD (Chronic Obstructive Pulmonary Disease) is a generalization for a catagory of diseases. It refers to two major chronic disorders: Emphysema and Chronic Bronchitis. Both of these diseases have been linked to cigarette smoking, however, people can get Emphysema and Bronchitis and never have taken a puff of a cigarette.

Cancer does not follow (generally) in the catagory of COPD. But like the above, some people can get lung cancer, and never have taken a puff of a cigarette. So, its hard to say which comes comes first or which will one follow.

Then there are the cases where somepeople can smoke 2-3 packs/day...and never-ever have any lung complications! I have the PFT's and xrays to prove it back at the hospital I work at!

In its entirety, Bronchitis is usually followed by Emphysema/Asthma...and if the cells have mutated...cancer sets in. It varies from person to person, and case to case.

As far as quiting goes, the way you are quiting is almost PERFECT. The cold turkey style is rarely sucessful and it has been documented that THAT method usually takes approx 10 attemtps before any success.

A smoker first needs to identify when he/she smokes. When you first wake up? During or after the morning coffee? In the car on the way to work? During lunch break? In the car on the way home from work? After dinner? Before bed? Most of these cigarette times are ROUTINE events. You expect to light up without even thinking. This is aside from the few you have when your out with your friends at the bar, at a ball game, watching tv...or what ever. The thing to do here is...cut out the routine cigarettes. First thing you need to do when accomplishing this is WILL-POWER. You have to want to stop. Make a date to start. TELL PEOPLE. Ask that they support you. Tell friends not to smoke around you. One by by...slowly, cut out those routine cigarettes. Skip the moring smoke when yer outta bed. Or perhaps, skip the morning smoke in the car on the way to work. Just do one for a while....a week or so. So you get used to the new routine. Then cout out another daily routine smoke. And keep going on and on. Smoking half a cigarette is a waste. You dont get the nicotine your body craves and what usually happens is you spoke more 1/2 cigarettes to compensate. Light cigaretts can even be worse. Studies have shown that people who smoke lights actually suck back harder and more forcefully. This is to get more taste, and more sensation in their lungs. Which in turn the tar deposit is greater!

Anyways, during your gentle cutback, it is infact a good idea to start suplimental nicotine treatments. See your doctor about the patch or chewing gum. It definately helps and will curve those cravings.

The biggest thing I can't emphacize enough about quitting smoking is you....WANTING TO STOP. You have to want to stop to actually stop smoking! You cant have the mentality: "Oh, just one now won't hurt".....once you do that....you've let your gaurd down and mostlikely wont be successful. Try getting a friend to stop with you. (with the above method) Support each other and set goal dates. As these dates are met...REWARD YOURSELF. Dinner and movie? Clothes shopping? New fishing pole? etc...etc.

Good luck my friend. Hope the above helped!

-Andy, RRT, CPFT
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Avatar_n_tn
Andy,

Thanks for your reply; I was actually hoping that you would respond, since I've read many of your comments and they all seem to get to the core of the issue....you sound like an experienced pulmonary physician, but if I may ask, what does RRT, CFPT mean?

Also, I have realized, in times past, that the most crucial component of quitting smoking is, as you said, wanting to quit.  I believe that most smokers fail in their repeated endeavors because they truly do not want to quit.  That said, it's natural for an addicted smoker to not want to quit, since most of us derive significant pleasure from smoking, and that's the rub.  It seems to me that most people invariably fail to quit when they're actually healthy.  It's when the doctor takes and x-ray and sees some pathology that scares most people and even then only some can quit.

Just recently I had a friend who is a ER doctor tell me that a pack-a-day for 10 years is not too detrimental, but after that, the chances of developing COPD rises significantly.  Here I am, at 26, approaching that 10 year mark, so it's the conception that I may one day get something that's irreparable that scares me and motivates me to stop now, as soon as I can.  My fear is my driving force, as COPD (and its ilk) is often irreversible and sure fire way to live in misery.

Again, it's tough, but I know I have to do it and am well on my way.  The other day I was thinking that 20 cigs a day x 30 days = 600 cigs a month, and 600 x 12 months = 7200 cigs a year, and 7200 cigs a year x 10 years = 72,000 cigs a decade.  Our precious lungs aren't meant to take that self-inflicted abuse.
I also read somewhere that if I quit now, the process of regeneration continues in the ensuing years, and after some time, I'd have the same risk of developing lung cancer/COPD/emphysema as a non-smoker.  I wonder if this is true....? In any case, there's no doubt that the lungs, at the very least, do not continue to degenerate.


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Avatar_n_tn
Thank you for your compliment. Its rewarding to get such positive feedback in this forum. I am a Registered Respiratory Therapist (RRT), and also credencialed as a Certified Pulmonary Function Technologist (CPFT). I have been practicing for over 14 years now. I am a former director of my own department. I have several other accolades including teaching college students, teaching Advanced Cardiac Life Support (ACLS) as well as teaching those that want to teach ACLS (Thats called an ACLS Instructor/Trainer). I did a few research projects that I wrote abstracts for. They have been published in the Respiratory Care Journal. Recently, I wrote a paper on one of them. Its going to be published next month and pending review for Chest Journal.

Your ER doctor friend couldn't be more correct. 10 years isn't along time, and your chances of getting COPD or any other severe lung disorder is rather low. I used to lecture at smoking cessation workshops throughout Boston and local elementary schools. One of the best strategies in teaching the awareness of smoking hazzards is the ole "SCARE TACTIC". I would suit up my scrubs, bring in a bunch of shiny steel eqiupment. Make sure there were lots of wires and dials...and tell them that this stuff helps you breath...."sometimes". Lots of pictures of decayed lung tissue. Pictures of tumors and all of the above. Smoking today has unfortunately become a benign sight to look at. We dont even look at someone and say, "Hey...thay dude is smoking!" (Remember the shock when Greg Brady was caught?) We dont get that reaction anymore. We're very passive as a community when smokers are around us. So, in a sense, its accepted (Aside from public areas and buildings) We gotta keep reminding what cigarette smoking does to you.

Another strong strategy is education people the benefits of quiting smoking. Unfortunately, people don't know that when you quit smoking, the body starts to heal within 20 minutes! Below is some facts we know. I teach this part during my lectures...and it amazes classes, strengthening their will to QUIT!!!!

These benefits are described chronologically below.

After 20 minutes
Blood pressure and pulse are normalised, blood circulation increases.

After 8 hours
The level of carbon monoxide in the blood falls. Improved fitness.

After 48 hours
Carbon monoxide due to tobacco smoke has disappeared completely.

After 2-3 days
Less or no phlegm in the throat, fewer breathing difficulties.

After 5-7 days
Your senses of taste and smell will improve, your breath is fresher, your teeth cleaner and your energy level higher.

After 2-3 weeks
The withdrawal symptoms will stop, your chemical dependancy is done, and you can now go several hours without thinking about smoking. Your risk of thrombosis is reduced.

After 4 weeks
Coughing, blocked sinuses and breathing difficulties should disappear. Less fatigue. More energy. The lungs are better able to resist infection.

After 2-3 months
The function of the lungs improves by 5%.

After 1 year
The risk of developing cardiovascular diseases is halved. Lung function can improve upto 20%. Lungs return to pink coloration

After 2-3 years
The risk of developing severe pneumonia or influenza is the same as for a non-smoker. (Secondary to improved mucocilliary escalator function)

After 5 years
The risk of lung, throat, oesophageal or bladder cancer is halved.

After 5-10 years
The risk of developing cardiovascular diseases or thrombosis is basically the same as for a non-smoker.

After 10 years
The risk of lung cancer is halved. The risk of developing osteoporosis decreases.

After 15-20 years
The risk of lung, throat, oesophageal or bladder cancer is basically the same as for a non-smoker. Heavy smokers, however, face double the risk of lung cancer for the rest of their lives.


Hope this gets you pumped up for your new path in life to a healthier you. Goodluck...and kick ***!

-Andy, RRT, CPFT
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Avatar_n_tn
On the record,

Just FYI i quit smoking cold turkey when i was 26, i am 47 now and never started again. I at the time saw a documentary on a  man in his 30's dying of lung cancer.  That scared me enough to throw the cigarettes away and never look back.
What helped me was being busy. Besides doing alot around the house, i sucked on tootsie pops and sipped wine here and there.
Once you have it in your mind to quit  YOU WILL.   It takes alot of will power but you sound like you have the strength and drive to rid yourself of such a harmful habit.

Good luck!!!
Lisa
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Avatar_n_tn
interesting topic, COPD is a major health problem world wide, it's the only disease that prevelance is increasing, and it's the fourth leading cause of death in north america. more than 80% of COPD patinets are smokers but only 15-25% of smokers are COPD patient, that's based on previous studies, but i think it's much more than this as screening methods not established for the general population but only for those who are smokers/previous smokers above the age of 40. lung cancer as well is the same storry as it may precede COPD and happens in non-smokers.

the success rate with quitting smoke is best with combination modalities that include behavioural therapy, nicotine patches, and zyban (35% success rate).

don't kill yourself, and others with this bad habit, and don't waste your money on this (imagine who much you spend in a year...you'll be shocked)
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A related discussion, List of times showing the benefits of not smoking was started.
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