The effect of smoking on loss of lung function over time

Today's column is dedicated to smokers. I just saw a patient that I have been seeing for the past 5 years. As my responsibility requires, I pointed out again, as I have at each visit, that her increasing symptoms, her declining lung function, and her increasing medication use are all the direct result of her smoking. Her health becomes increasingly and irreversibly affected. Her response was angrily to ask me why couldn't I give her better and less expensive medications to reduce her symptoms.

To the left is a very famous study of the effects of lung function with increasing age in groups of people who did or did not smoke. Every medical student had to memorize this chart, because we were tested on it. Even non-smokers have a mild decline in lung function over time, because their lungs are getting older. Regular smokers have a much accelerated rate of loss of lung function, resulting in a much higher chance of symptoms, disability and finally death at an early age. Interestingly, if smokers stop, the rate of decline decreases to that of the non-smokers. That's good news. The bad news is that lung function that is lost remains lost. The comment above is also stunning and true in my practice.

Conclusions: stop smoking or using tobacco products ASAP. Try not even get exposed to second-hand smoke from any tobacco products. These are inflammatory comments, especially since I'm writing this from South Carolina, whose economy is in part dependent on growing tobacco. But it's the truth.

Soon smokers at least employed by the state of South Carolina will be paying higher premiums. It's their choice.

If you have questions about smoking and accelerated loss of lung function, ask your doctor.