What Causes COPD Progression If I Stopped Smoking?
What Causes COPD Progression?
Dear Dr. Mahler:
I’ve read that if one stops smoking that emphysema damage doesn’t get worse. If that is correct, what causes COPD to progress in someone with emphysema who quit smoking?
Also, which has a worse prognosis, emphysema or chronic bronchitis?
Thank you for your time.
Shannon from Topeka, KS
Dear Shannon:
Previous definitions of COPD included the statement that COPD was “usually progressive.” Progression is determined by a decline or worsening in breathing test results (lung function) over time. In healthy adults, the decline typically starts at age 40 years or so. It is due to loss of elastic fibers (elasticity) in the lungs, and similar to the loss of elastic fibers in the skin. This is part of the aging process.
FEV1
FEV1 is the amount of air exhaled in one second. It is used to assess progression of COPD
Changes in the amount of air exhaled in one second (abbreviated FEV1) is used to assess progression. In healthy individuals, the decline is quite variable. In women, the average decline in FEV1 is 25 milliliters/year, while in men the average decline in 30 milliliters/year. The difference is because men have higher lung function than women.
On July 1, 2019, I posted information on this website that COPD progresses in 18 – 36% of those with COPD based on results from three different studies. You may wish to read this post. Here is another reference to read about preventing progression of COPD.
You are correct that damage to the the lung with emphysema does not progress once your stop smoking cigarettes and avoid inhaling “bad air.” However, as mentioned above, there is an expected slow decline in breathing tests due to aging alone.
Your other question was about, “Which has a worse prognosis, emphysema or chronic bronchitis?” Although emphysema and chronic bronchitis are the two types of COPD, many individuals have features of both. In general, shortness of breath is the major symptom of emphysema, while daily cough and mucus are the major symptoms of chronic bronchitis.
Please note, the advice provided is not a substitute for asking your health care professional about your specific situation.
Sincerely,
Donald A. Mahler, M.D.