5 Reasons Why People With COPD Continue to Smoke
How many times has your spouse, close family member or best friend nagged you, unsuccessfully, to quit smoking? Chances are, there are too many to count. For reasons not completely understood, smoking cessation and COPD is an complex issue that isn't always forthcoming with well-understood answers.
Perhaps the key to successful smoking cessation lies in understanding the reasons why so may people who have been diagnosed with the disease continue to smoke. Gaining insight into what motivates you to smoke just may pave the way to successful smoking cessation.
Despite overwhelming evidence that smoking contributes to worsening airway obstruction and early death from COPD and/or other chronic health conditions, smoking cessation rates in smokers with COPD are poor. Considering that quitting smoking is the primary intervention in managing the disease, understanding why you don't want to quit, or want to quit but can't, may pave the way to you finally achieving smoking cessation success.
1. Why Quit Now? I Already Have the Disease
Although the majority of smokers with COPD realize that continuing to smoke contributes to worsening lung function and a decline in overall health, studies suggest that many people falsely believe that, because they've already been diagnosed with the disease, there's no reason to quit. Nothing could be further from the truth. There is always a health benefit to quitting smoking, no matter what stage disease you're in. In fact, lung function decline in COPD can actually normalize in some patients who quit smoking, meaning that once you quit, your lung function will decline at the same rate as anyone else of the same age, sex, height and weight.
2. Lack of Internal Motivation to Quit
Current research supports that, in order to maintain autonomy, the decision to stop smoking has to come from within. Despite awareness of the consequences of tobacco consumption, all the nagging in the world by well-intentioned loved ones won't help someone quit if they lack the internal motivation to do so. Although some studies suggest that motivation to quit smoking is elicited by worrying about future health problems, other studies show that unpleasant respiratory symptoms are simply not enough to convince a person to jump aboard the quit-smoking bandwagon.
3. It's a Lifelong Habit That's Difficult to Break
For some people, smoking cigarettes is a lifelong habit that is consequentially, very difficult to break. In fact, studies suggest that smoking initiation at a young age is strongly associated with a lifelong dependence on smoking. What makes quitting so difficult? Smoking is often associated with pleasant events and positive feelings, such as smoking after a meal, during a coffee break at work or when drinking alcoholic beverages. Some people even consider smoking a reward after a long day on the job or doing a good deed. Others revel in the feeling they get from just holding a cigarette between their fingers and will light up even when they don't have a craving to smoke.
4. Never Finding the Right Time
If you cite having a hectic, worrisome lifestyle as one of the reasons you still smoke, you're not alone. Many people with COPD attribute their chaotic lifestyles to why they can't quit smoking, even when they don't necessarily long for a cigarette. Additionally, some people associate smoking with comfort and suppression of worries and feel they'll be tossed out of their comfort zone if and when they finally decide to quit. Those who are dealing with chronic illness or death of a loved one often postpone the occasion to quit, feeling justified when they do so because of the stress they're under. Some people experience weight gain after they quit, which weakens their resolve to remain abstinent and eventually compels them to start smoking again. If you're struggling to find the right time to quit smoking, chances are, you'll be struggling forever. The key to smoking cessation is making the right time, right now.
5. Smoking Continues to be Pleasurable
Perhaps the number one reason why people don't quit smoking is because they continue to enjoy it. Even the most hazardous of consequences don't seem to override the pleasure one derives when lighting up and taking a long, extended drag off that first cigarette. Because addiction to nicotine is so strong and is related to sensations of pleasure, smoking eventually becomes a habit that is difficult to break.
Lung Function Decline in COPD After Smoking Cessation
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 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.
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!