Smokers: Most of them have lungs

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MunichThe proportion of those with lung disease among smokers is much higher than previously assumed: In eight out of ten, the blue haze has already attacked the lungs. Even with many who have no breathing difficulties, X-rays often show the first signs of COPD - a chronic obstructive pulmonary disease.

While doctors have previously assumed, based on common lung function tests, that around half of all smokers are affected, a current study with more than 8,800 cigarette users reveals the true extent of tobacco-related lung damage for the first time. The frightening result: even 80 percent of all "smoker's lungs" are damaged.

Suffering lungs

A lung function test called spirometry is usually done to diagnose COPD. It measures how much air the patient can inhale and exhale in one second. But this test is apparently not enough: a large part of the lungs that have already been attacked are not detected, shows a study at the National Jewish Health in Denver.

The scientists examined 8,872 active and former smokers between the ages of 45 and 80 years. All had smoked at least one pack of cigarettes a day for at least ten years. In around half of the participants, the pulmonary function test showed no signs of COPD. Her lungs were found to be healthy.

Shortness of breath & emphysema

However, additional examinations revealed a different picture: In 42 percent of the participants previously classified as healthy, the computed tomography showed changes in the airways or even distended lung sections - a so-called emphysema. 23 percent suffered from shortness of breath, 15 percent managed less than 350 meters in six minutes in the walking test.

More than a quarter also rated their quality of life as clearly restricted in a questionnaire. Overall, more than half (55 percent) had some form of lung health impairment. The scientists assume that these are early signs of COPD.

Premature all-clear

"The result clearly shows that the majority of smokers have chronic lung diseases - even if many of them do not notice anything and believe that they are not affected," warns Prof Hans-Ulrich Kauczor from the Heidelberg University Hospital, who is involved in the German-American study was.

COPD is an insidious disease that is often fatal. Typical of this is the so-called smoker's cough, a chronic bronchitis that is not caused by pathogens, but rather on attacked lung tissue. The lungs often suffer unnoticed for a long time. Symptoms such as shortness of breath or morning cough are often not taken seriously enough by those affected.

No cure possible

The fatal thing: The progressive destruction process is irreversible - in later stages severe shortness of breath occurs, the oxygen mask becomes a constant companion. . COPD is now one of the most common causes of death - worldwide and also in Germany. “If left untreated, COPD will progress inexorably,” says Kauczor.

Measurable breathing restrictions only become noticeable when a quarter of the lung tissue has already been destroyed. “Until then, there is plenty of room for considerable damage that those affected do not consciously perceive or do not want to perceive. The aim here is to raise awareness through appropriate advice, ”advise the researchers.

Early therapy recommended

The experts recommend using medication in the form of inhalation sprays earlier than before if the symptoms are affected, even if the pulmonary function test does not yet give cause for concern. The prerequisite, however, is that the patient quit smoking, otherwise the treatment would not be successful anyway, according to the lung specialists.

Around eight million people in Germany suffer from COPD, and over 100,000 die every year as a result of creeping lung failure. Around 90 percent of those affected are or were smokers. (cf)

Source: Clinical and Radiologic Disease in Smokers With Normal Spirometry, JAMA Intern Med. 2015; doi: 10.1001 / jamainternmed.2015.2735

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