Smoking kills. Although many activities involve some risk, smoking is an activity that systematically reduces viability and life expectancy. This reduction in life expectance is directly related to how much one smokes. That is, the people who smoke the least (non-smokers) have the least risk of death, and those who smoke the most, have the greatest risk of death, assuming all other factors are controlled for. This cannot be said of any other legal substance, including alcohol.
Alcohol, while toxic in large quantities, has some residual health benefits in small amounts. A person who has one drink every few days has less risk of death than someone who drinks not at all. While the risk for cancer goes up with a direct correlation to alcohol consumption, moderate amounts of alcohol decrease risk of heart disease. And, since heart disease is a greater cause of death than cancer, the tradeoff results in less risk of death.
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By contrast, smoking has zero positive effects. Every single effect smoking has on the body, in any amount, is negative. One of these negative effects is chronic obstructive pulmonary disease, or COPD as it is commonly referred to among the medical community. COPD is actually not one disease but a raft of conditions, most notably chronic bronchitis and emphysema.
Bronchitis is a condition characterized by excessive mucus in the lungs and pulmonary tract. The condition is considered chronic if symptoms exist most days for three months per year in two consecutive years. Often diagnosed because mucus in the lungs is coughed up, bronchitis has other less obvious symptoms, including shortness of breath, chest pain, fatigue, or fever. The excess mucus is produced by goblet cells that increase production, often in response to some irritant, such as tobacco smoke. Clinical studies are underway to more comprehensively understand the causes of this in non-smokers.
Emphysema is a condition characterized by an enlargement of the alveoli in the lungs. The alveoli are tiny sacs that greatly increase the available surface area of the inside of the lungs, and if the tiny sacs and folds were completely flattened out, the lungs would be about the size of a tennis court. This surface is where oxygen and carbon dioxide are exchanged, and sufficient area is necessary for sustaining the life of the body. Emphysema enlarges the alveoli by breaking down walls between them, and resulting in a net loss in surface area.
This loss in surface area of the alveoli is not noticeable at first, but then the sufferer will begin to experience shortness of breath when undertaking intense activity. Eventually, even the gentlest exertion will cause shortness of breath. In extreme cases of emphysema, shortness of breath is experienced when at rest.
While the majority of COPD cases are in smokers, a significant percentage of them are not. It is these non-smoking COPD cases that ignite the curiosity of researchers. COPD clinical research seeks to determine the causes of the condition, especially in non-smokers, and work out viable solutions for treatment.