How Do Smoking Cessation Programs Help Manage COPD Symptoms?

Smokers' airways are hyper-reactive, meaning they sometimes can be hyper-responsive to non-noxious stimuli also, and smoking cessation is found to prevent further progression of airway hyper-responsiveness.

Smoking is the most critical; thus, it is of paramount importance to consider smoking cessation as it is the only intervention. Cigarette smoke contains 1000s of noxious gases and particles like Co2, CO, oxides of nitrogen, and sulfur. These harmful particles, on inhalation, act on the airway cells to incite an inflammatory reaction. This inflammatory reaction is characterized by an influx of cells and cellular products, various chemical mediators secreted by these cells, and the normal respiratory epithelial cells. These chemical mediators and inflammatory cells bring out many changes in the airway wall structure and function. Some of which are transient, and some are permanent.

Effects Of Smoking In COPD

• Some of the effects are an increase in the number and size of the mucosal glands, which makes them secrete more viscous and comparatively more significant amounts of mucus. This viscous mucus is one reason for caroming cough and sputum production in smokers, and when it persists for a long time, it causes chronic bronchitis.
• The noxious particles from the fumes also damage delicate hair-like structures on the respiratory epithelium called cilia. They help clear respiratory secretions and any foreign particles, including bacteria and viruses, that gain entry into the respiratory tract. Damage to these cilia means incomplete clearance of the secretions and increased susceptibility to infection.
• These inflammatory changes, when left unchecked for many years due to chronic smoking, can cause permanent changes in the airway architecture, making the disease process irreversible. The breathing tubes become narrow and fixed, causing breathlessness and wheezing, characteristics of COPD. This inflammation also damages the air sac, affecting the gas exchange and in advance disease; this is the reason for low oxygen and increased carbon dioxide in the body.

How Do Smoking Cessation Programs Help Manage COPD Symptoms?

• Depending on the degree of smoking history, the inflammation in the airway may or may not completely reverse. However, studies have found a significant reduction in smokers' symptoms after stopping smoking. They report fewer episodes of cough, sputum production, and wheezing.
• Due to breathlessness's multifactorial nature, the effects of smoking cessation on breathlessness may be variable. Hence, some people may perceive improvement in breathlessness after quitting smoking, and some may not. The improvement in symptoms is more profound in smoking cessation in people who have not developed significant airflow limitations before quitting.
• Smoking also causes an accelerated decline in lung function, and quitting smoking can slow this rate of decline in lung function. Some studies have shown normalization of the rate of lung function decline after 2 years of quitting.

Conclusion

However, the architectural changes in the airway structure brought on by chronic inflammation, such as mucus gland enlargement, airway wall fibrosis, air sac wall damage, and loss of airway attachment, may not be completely reversible when smoking is stopped. This is the cause of COPD's irreversible nature.