Maybe Smoking Should be Illegal...

I smoked heavily for 43 years. In April 1999 I finally quit for good. I had COPD.


Taken from the European Respiratory Journal, Vol. 20, Number 4


Currently ranked 6th among the causes of mortality in the world, chronic obstructive pulmonary disease (COPD) could well move up another three places within less than 20 years, besides constituting the 5th cause of morbidity. This rise is linked to that of smoking, which is the principal risk factor where COPD is concerned.

It may be recalled that COPD is similar to asthma insofar as it affects the lower airways, but differs by its steady but irreversible progression.

In 2002, a study, under the name “The Confronting COPD International Survey”, was conducted in the United States, Canada and six European countries (France, Italy, Spain, Netherlands, Germany and United Kingdom). The subjects selected were 45 years and older who had at least 10 pack-years of smoking, which meant that they had smoked the equivalent of a pack a day for at least 10 years, and who had been diagnosed with COPD, emphysema or chronic bronchitis. Failing that, they had to show symptoms of chronic bronchitis, namely persistent coughing with phlegm or sputum from the chest for three months in the last two years or more.

One of the most surprising outcomes of this study concerns the degree of awareness of patients and their behavior. Although by definition all the subjects were affected by COPD, only 20% could name their illness correctly, and almost half (46.2%) continued to smoke, despite the fact that smoking had not only played a key role in causing their disorder but also was a directly aggravating factor.

Moreover, and this is one of the most remarkable findings of the study, it turns out that patients underestimate the severity of their illness. As the authors write, “in individuals objectively scoring 3, 4 and 5 in the MRC dyspnea scale, who had answered yes at least to “I have to stop even when walking at my own pace” or “ I walk slower than most people my age”, 75%, 60% and 36%, respectively, considered their disease as only mild or moderate”!

Daily activities in COPD subjects were compromised, regardless of the subjects’ age: about two-thirds of the patients said that their physical or leisure activities were restricted, while one third slept badly, had difficulty performing household chores or found their sex life impaired.

In The Confronting COPD International Survey, moreover, 12.8% of participants reported at least one hospitalization during the year, while 13.8% had required emergency care due to respiratory difficulties.

An excerpt from Dave's Story...

Between February 2002 and February, 2003 I had 12 severe asthma attacks that required a 911 call to restore my breath. In between were many, many car trips to the emergency room for a "masking". I want to try to attempt to describe in words what those attacks felt like. I could feel my airways begin to close and knew I was about to be given some severe punishment. My only thought was to get some air and yet, as hard as I fought could not get any. My chest heaved, wildly; I would sweat profusely; I couldn't get enough breath to call for help. I "felt" the meaning of suffocation. I thought I was going to die. This is life for a COPD sufferer. Eventually one of these attacks overloads the hearts capabilities.

Dave's Story...The Journey Back

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