Today I want to share with you my views on smoking and link it with COPD (as promised mid week). The title of this piece sums it up really for me. The quote comes from my playing days where all of the lads would use it (the majority of the time it was used on nights out when the we would have had a few too many beers). Now, I’m not saying that everyone that smokes is a joke – far from. The point that I am making today is that from my own personal point of view. When you actually learn about the effects smoking has on the body, to then write a 5000 word essay on what smoking does to the body, you soon realise that you are best off leaving the ‘death sticks’ well and truly alone.

Having researched and studied the effects that smoking has on the body you soon learn that you need to do all in your power to help people stop smoking… However, I do know that everybody has their own free will. I can only educate you guys on what effects that smoking has on the body, provide you with the facts for you then to do something about it! I seem to find myself saying a lot ”I can only help you as much as you are willing to help yourself”…

For all of you who didn’t know, smoking is closely linked with a progressive disease called ‘Chronic Obstructive Pulmonary Disorder’ AKA COPD. I would like to educate you on the effects that smoking has on the lungs in Lehman’s terms as I think that it’s important for you to know what damage you are doing. Here goes…

So, I will start by explaining about the cough reflex.  The cough reflex is there to clear mucus from the lungs. Increased amounts of mucus within the lungs is a bad thing to have as you are more likely to develop diseases and bacterial infections. The cough has three phases; inhalation, forced exhalation against a closed glottis and finally a violent release of air when the glottis opens. —This creates a shearing force which mobilises sputum (AKA phlegm or ‘greeny’ depending where you are from) into the mouth. Here it can be disposed of. It is known that the cough reflex is initiated by stimulation of the airways sensory nerves; basically that means that you cough if your airways are tickled – makes sense right? An increase in coughing causes an inflammatory response, leading to scarring (fibrosis) and hypertrophy (an increase in size) of the airways.

Inhaled tobacco smoke contains noxious particles that act as an irritant to the cells that line our windpipe and lungs (known as the trachea and bronchial tree medically). These cells are called ‘goblet cells’. Goblet cells are responsible for the secretion of mucus AKA phlegm. With an increase in size of the airways walls there is an increase in mucus that is secreted. If your lungs make these changes then your lungs become a ‘more than ideal’ environment for bacteria to grow in (a superior incubator if you like- warm, moist, cosy and snug). If you smoke then you may notice that you have a ‘winter cough’ that is more often than not productive (a productive cough basically means that when you cough you get a nice big ‘greeny’ in your mouth that you will either spit out or swallow depending how hungry you are…).

By now, not only do you have increased mucus production; your lungs have adapted by becoming scarred and your airway walls have become thicker. I spoke to you earlier about how the cough is there to act as the bodies own mechanism to remove mucus from the lungs and into the mouth. I am now going to educate you on how the ‘mucus’ gets to the point within the airways that initiates the cough reflex.

We all have what we call a muco-ciliary transport system within our lungs… This system is predominantly made up of what we call ‘cilia’. Cilia are tiny little hairs that waft simultaneously to move mucus toward the centre of the lungs – here is where we cough it up. So imagine a mexican wave for me if you will or alternatively a wave in the ocean with a surfer on it… The surfer can continue to ride the wave as long as the wave remains unbroken. Agreed? This is how these ‘cilia’ act. There have been studies done that prove that when you smoke this mucociliary transport system does not work efficiently.

So this is where the problem is… Your lungs keep in all of that mucus just because the ‘cilia’ have gotten lazy and they have decided not to stand and wave their arms to the sky when its their turn. Again all of these actions are adapting your lungs to become a SUPER BACTERIAL INCUBATOR.

And the cycle just goes on and on and on. So, you currently may be young and thinking to yourself .‘so what?!? Im still young, theres plenty of time to stop’. Let me tell you this. The damage you are doing is already done to your lungs. Let me explain to you what living with COPD is like. To do that I am going to tell you about my precious Gran who only recently became diagnosed with COPD as I insisted she went for some easy tests with her GP.

My Gran has to be one of the nicest people you will ever meet. Two Christmases ago I went down to visit her and she began telling me how breathless she had been recently. She explained to me that there was so much that she enjoyed doing that she couldn’t even do anymore. She also told me that she commonly had a productive cough. It all started by her noticing that she was really labouring just to get around the local shopping market; feeling like she was running a marathon yet she was only walking. She then had to keep taking regular breaks whilst making her way around Morrisons.  Every time she went shopping, the amount of breaks she had to take to catch her breath was increasing. She then found herself not wanting to go out of the house anymore as her confidence was gone – this led to her being even more breathless when she did anything. This then made her feel depressed. It is known that depression runs hand in hand with this disease. This is why it is so important for you to reach out to any loved ones that you know who have similar problems.

Her way of living with it/describing it to me was like this… ‘Imagine having to breathe through a straw every single day; can you imagine that Liam?’ She then listened to my advice and informed her GP about it. Her care and management then changed and now she is an awful lot happier in life.

There is a cycle that people with COPD need to avoid at all costs and it looks a little like this:

Decreased exercise tolerance  leads to social isolation and inactivity. Inactivity leads to muscle further deconditioning and social isolation. This then leads to further decrease in exercise tolerance. When somebody you love is falling into this cycle then surely you would do something to help them?

‘What I need you all to understand now is how common COPD is. It is definitely known that there are approximately 900 000 people within the UK alone diagnosed with COPD. There are an estimated 2 MILLION people out there that are in the UK living with this disease who remain undiagnosed. This is a major problem as the care that you receive when diagnosed changes dramatically.

 ‘Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease state characterised by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking. Although COPD affects the lungs, it also produces significant systemic consequences.’

ATS, (2006)

Re read the first line of that quote for me… COPD is PREVENTABLE. Stop smoking. Exercise more. Invest some time in your health.

If you know of anyone that smokes, or alternatively if you know of anyone who has symptoms of COPD I am calling on you guys to help these people make the right decisions. Don’t suffer or settle for a life of struggle when you are older. Inform your GP. Stop smoking. And start to invest in your health today.

Rememeber, If you smoke, you’re a joke!

Much love as always,

Liam