How Does Smoking Increase Risk of Emphysema (Over Age 40)

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The risk of developing emphysema rises with both the duration and frequency of cigarette smoking. Men who smoke face a 17-fold higher risk of dying from chronic obstructive pulmonary disease (COPD) compared to non-smokers. Similarly, women who smoke are 12 times more likely to die from this respiratory disease than non-smokers [1]. And the risk might increase seriously with age, particularly over age 40!

Emphysema, typical age of onset

While the risk of developing the disease may increase with advancing age, it is not an inherent part of the aging process. Simply being older does not independently lead to emphysema.

The primary factors contributing to the risk of the disease include age and other elements, such as prolonged exposure to cigarette smoke or industrial chemicals over an extended period. COPD is most commonly observed in individuals over the age of 40, particularly those who currently actively smoke or have a personal history of smoking [2].

How about at younger age? While the progressive nature of emphysema might make it less probable for a young, it remains a possibility. Even though risk factors may not have accumulated sufficiently to cause the disease, individuals in high-risk categories, such as heavy smokers or those working in polluted environments, should remain vigilant about the potential risks and take preventive measures.

A genetic condition known as AAT (alpha-1 antitrypsin) deficiency can increase your risk of COPD at any age. About 100,000 people in the U.S. may have this deficiency disorder, according to the National Heart, Lung, and Blood Institute.

This deficiency disorder hampers the body’s ability to respond to lung damage. Consequently, it is likely to accelerate the development of emphysema or COPD compared to others. In such cases, individuals may have never smoked or been exposed to harmful chemicals and pollutants, yet they still face a high risk of developing COPD.

How does emphysema progress with age? The progression of COPD can vary from one case to another, but individuals may commonly encounter general symptoms both before their diagnosis and as the disease advances.

The speed at which symptoms manifest differs based on various factors, including treatment options you’re taking, your age, and stages (severity) of the disease!

The same goes for outlook and prognosis of emphysema. This is variable and influenced by numerous factors. Although the disease is a progressive condition, but it’s manageable. Early diagnosis and treatment can be highly beneficial, as there are interventions and lifestyle adjustments that may effectively slow down the disease’s progression.

How does smoking increase the risk of emphysema?

The physical damage inflicted on the lungs by exposure to tobacco smoke or the toxins released in tobacco products may lead to respiratory diseases, including emphysema. This explains why individuals working in hazardous environments, such as miners, have an elevated risk of developing emphysema due to continuous exposure to polluted air.

Most experts believe that smoking doesn’t directly cause emphysema but would significantly contribute to its development. Like many respiratory diseases associated with smoking, pinpointing an exact cause can be challenging, but emphysema is known to be one that could emerge due to tobacco smoking.

The chemicals and particles present in tobacco smoke induce irritation, progressing into inflammation. This process particularly affects the delicate walls of the alveoli in your lungs, which, with sustained exposure, eventually undergo serious destruction.

Consequently, the normal exchange of oxygen (O2) and carbon dioxide (CO2) becomes less effective, resulting in impaired breathing—a main characteristic feature of emphysema and CPOD.

How long does it take for emphysema to occur in smokers? One study that analyzed responses from a 2012 survey focusing on adults over aged 45, researchers investigated the incidence of COPD based on respiratory histories. The study involved 4,135 adults with a personal smoking history!

1,454 participants had a smoking history of 30 or more years, with nearly half of them being current smokers. According to this study, this subgroup got the highest incidence of emphysema and COPD. On the other hand participants who had quit smoking at least 10 years prior had a lower rate of the disease compared to those who were still actively smoking [3].

This suggests that there is a direct correlation between the extent of smoking and the likelihood of developing respiratory symptoms (frequent productive cough, frequent shortness of breath, and reduced physical activity due to smoking for examples).

So the risk of developing emphysema tends to increase with the extent of smoking, and sustained tobacco smoking will provoke to more advanced stages of the disease!

How about vaping? While the majority of attention is often directed at tobacco smoke, vaping also has been associated with popcorn lung, a condition that results in scarring and damage to your lung tissue.

Similarly, the act of smoking cannabis may have a role in increasing the risk of emphysema or CPOD. Even this might lead to a greater deposition of tar in the lungs compared to conventional cigarette smoking.


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