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Lung Function Decline in COPD After Smoking Cessation

The Rate of Lung Function Decline Should Slow Down After Quitting

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Updated October 29, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Smoking Cessation in COPD

No More Butts

Photo © istockphoto.com, user Stepan Popov
Many people with COPD wonder why they should quit smoking after they are diagnosed. After all, since the damage to the lungs from COPD is irreversible, why quit? The truth is, every bit of scientific evidence about smoking cessation and COPD points to the fact that lung function decline (as measured by FEV1) in COPD slows dramatically once you quit. In fact, most research supports that it actually normalizes, meaning it declines at the rate of anyone else of the same age, height, weight and sex.

But like anything else, there are exceptions to the rule, and when it comes to COPD, there are those whose lung function declines much more rapidly than others. These people are sometimes referred to as rapid decliners.

Factors Contributing to Rapid Decline of FEV1

According to the American Journal of Respiratory and Critical Care Medicine, if your lung function declines more rapidly than others, you may be at an increased risk for hospitalization and death.

What determines how fast your lung function will decline if you have COPD? These are potential risk factors for being in the rapidly declining group:

  • Continuing to smoke
  • Having frequent respiratory infections
  • Having a genetic predisposition to rapid lung function decline
  • Having other illnesses that may contribute to worsening lung function
  • Having advanced disease
  • Being age 50 or older
  • Being female
  • Being of African American decent

Why Quit Smoking?

Research published in the European Respiratory Journal suggests that smoking cessation improves COPD symptoms, reduces airway hyper-responsiveness, and "normalizes the excessive FEV1 decline in all stages of the disease." Quitting also improves survival in people with COPD.

Additional research from the Lung Health Study found that in those who quit smoking, there was a significant reduction in lung function decline compared to those who continued to smoke. In fact, those who quit experienced an improvement in lung function in the first year after quitting. In subjects who remained smoke-free, the rate of decline in FEV1 was 31 milliliters per year; half that of the continuing smokers group (62 milliliters per year). These differences increased progressively year after year during the study follow-up period of 11 years. At the 11 year mark, 38% of those who continued to smoke had an FEV1 of less than 60% of the predicted normal value compared to 10% of the sustained quitters.

Smoking cessation has many other benefits as well. About.com's Guide to Smoking Cessation shares the rewards of quitting after the last cigarette.

How To Prevent a Rapid Decline in Lung Function

Once you reach a certain age, lung function declines as a result of the natural aging process. When you add smoking to the mix, however, the rate of lung function decline occurs even faster. If research shows that smoking cessation is the single most effective way to slow the progression of COPD, why do so many people continue to smoke?

Smoking is an addiction and, as such, should be treated that way. Using an all-encompassing approach that includes medications, counseling, meditation and relaxation, quit smoking support groups, proper nutrition, and daily exercise works best if you are trying to quit. In addition, many find that the 12 Steps of Nicotine Anonymous, a program based on spiritual principles, helps them succeed when all else fails.

If you have tried to quit and been unsuccessful the first time, don't give up. In the beginning, many people try in vain to quit and are finally successful after subsequent attempts. How do you begin? Start by educating yourself with the following information:

What else can you do to help preserve your lung function? Here are some additional tips:

  • Eat a diet high in antioxidants. A healthy diet rich in antioxidant vitamins like A, C, E, and selenium may be associated with better lung function and higher levels of FEV1.

  • Avoid long-term exposure to indoor and outdoor air pollution. This means creating a smoke-free environment in your home, avoiding exposure to wood burning stoves, biomass fuels or harsh chemicals, and staying indoors on days when air quality is poor.

  • Exercise daily. Research suggests that moderate to high levels of regular physical exercise are associated with reduced levels of lung function decline and risk of COPD in smokers. Imagine what exercise will do for you if you quit!

For more information about smoking cessation, visit About.com's Smoking Cessation site.

Sources:

Nicholas R. Anthonisen MD et. al. Effects of Smoking Intervention and the Use of an Inhaled Anticholinergic Bronchodilator on the Rate of Decline of FEV1 The Lung Health Study. JAMA. 272 (19). November 16, 1994.

Judith Garcia-Aymerich1 et, al. Regular Physical Activity Modifies Smoking-related Lung Function Decline and Reduces Risk of Chronic Obstructive Pulmonary Disease; A Population-based Cohort Study. Vol 175. pp. 458-463, (2007).

B.W.M. Willemse, D.S. Postma, W. Timens, and N.H.T. ten Hacken. The impact of smoking cessation on respiratory symptoms, lung function, airway hyper-responsiveness and inflammation. ERJ March 1, 2004 Vol. 23 No. 3 464-476.

Richard E. Kanner, Nicholas R. Anthonisen and John E. Connett. Lower Respiratory Illnesses Promote FEV1 Decline in Current Smokers But Not Ex-Smokers with Mild Chronic Obstructive Pulmonary Disease. Am. J. Respir. Crit. Care Med., Volume 164, Number 3, August 2001, 358-364.

David M. Mannino, Matthew M. Reichert and Kourtney J. Davis. Lung Function Decline and Outcomes in an Adult Population. The Am. J. Respir. Crit. Care Med., Vol 173. pp. 985-990, (2006).

Néstor A Molfino. Genetic predisposition to accelerated decline of lung function in COPD. Int J Chron Obstruct Pulmon Dis. 2007 June; 2(2): 117–119.

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