Goshen News, Goshen, IN

September 25, 2013

Smoking ranks as the number one cause of COPD


— GOSHEN — In June, the American Lung Association released a disheartening report about the rise of chronic obstructive pulmonary disease in women.

The report showed that women are 37 percent more likely to have COPD than men and account for more than half of all deaths attributed to COPD in the United States.

“The number one cause of COPD is tobacco smoke,” according to IU Goshen Health Pulmonary Rehab Coordinator Tim Near.

There are other causes, including having a genetic predisposition for it, chronic exposure to environmental dust and dirt whether from geographic living conditions or the workplace, repeated exposure to second-hand smoke or exposure to coal dust, industrial dust or chemicals, he said.

Falling under the COPD label are emphysema and chronic bronchitis.

But with women, Near said, tobacco is one of the main causes.

A lot of marketing for and against cigarettes is directed toward women

“So when we talk about the rise of COPD in women, with tobacco being one of the main causes — this is simplified,” Near said, “because when you read through (the report) there are many, many variables: the amount of education, income disparity … but in general one of the big things they mention is the marketing toward women in the mid-century and later, between the 1950s and ’70s through their — the Virginia Slims’ ‘You’ve come a long way baby.’”

“It was a very real image for women to be independent,” he said, “to be something that was an individualistic identity — freedom.”

Some of the lung issues women are experiencing, he said, it’s a speculation that it’s a result of that.

“How much is equality in healthcare from men to women, I don’t know, but there’s some of that, too,” Near said.

Diagnosis of COPD

For a diagnosis of COPD, a patient have symptoms, which include increasing shortness of breath with activities; repeated lung infections; and difficulty to exhale air, which shows up during a pulmonary function test. This test shows the exhalation volume and if flow is decrease.


The number one response to help COPD is quitting tobacco use.

“The lining of your lungs can rejuvenate — yes,” Near said, “but the majority of the effects of tobacco use are permanent. Now with following the treatment for COPD you can slow the progression and even ... some people can even stop the progression with medication and lifestyle changes and pulmonary rehab concepts and such that have to do with exercise.

“Physical exercise is incredibly important with COPD,” he said. “It’s paramount.”

Pulmonary rehab, Near explained, is a program of exercise therapy and self-management education.

“The damage to the lungs is permanent,” Near said. “With conditioning and strengthening you’re looking at the holistic approach of treatment. In other words, you’re not going to change the lung function, as much as you’re going to change the way your body supports your lung function.”

With aerobic and resistance exercise people can help themselves be active. “You don’t need as much oxygen to be active,” Near said of the benefits of exercise. “If you have compromised oxygen intake, your breathing is better. That’s the core concept.”

There’s also a tremendous amount of learning involved in rehab, he said.

Breathing and anxiety go so close together, Near said, adding, “By being physically active, even though short of breath, in a controlled environment .. folks can learn a measure of control over their shortness of breath. It’s a basic tool with folks who deal with chronic shortness of breath.”

People who have shortness of breath, tend to avoid exercise like the plague, Near said. By gradually introducing patients to exercise over the typical three-month period they are in rehab, they learn to gain control and not experience the anxiety that goes with exercise.

Eating a nutritious diet is important as well, Near pointed out.

But quitting tobacco is number one.

Tobacco smoke has 4,000 chemicals — 60 are cancer causing, Near said, adding that there hasn’t been enough research to know the effects of many of the other chemicals.

“Of course, seeing their physicians and getting a good treatment plan established with their doctor is important,” he said. “Good medications — oral and inhaled can be very helpful. A pulmonologist can be very helpful.”

And there’s also supplemental oxygen. “It is a fantastic support for folks who have chronic lung issues,” Near said.

Be informed

There are daily factors that can affect the life of a person with COPD, and Near suggests people make themselves aware. Days including high humidity, pollution or ozone action days should probably be days people with COPD stay inside in air conditioning.

The hospital offers a monthly meeting for people with lung problems. Those people are often interested in reading reports like the ones issued by the American Lung Association, Near said.

For those who would like to attend, the group, Better Breathers Club meets on the first Thursday of each month, March through November, at 4 p.m. in the Arbor Conference Center at IU Health Goshen Hospital.

A lot of times with chronic health issues, such as these, more information is always peace of mind, Near said. Psychologically it’s helpful to know there’s more information being gathered and people are paying attention to their issues.