How COPD Patients Can Slow Down Lung Function Decline

Why Quitting Smoking and Other Strategies May Help

Senior man weight lifting
Daily exercise can help. Marc Romanelli/Blend Images/Getty Images

Many people with COPD wonder why they should quit smoking after they've been diagnosed. Since the damage to the lungs from smoking has already been done, you may wonder, "Why bother?"

The truth is that every bit of scientific evidence about smoking cessation and COPD points to the fact that lung function decline in COPD tends to slow dramatically once you quit, so putting down those cigarettes—even later in life—can still be beneficial.

In fact, most research supports that lung function is likely to normalize, meaning that it declines at the rate of anyone else of the same age, height, weight, and sex.

However, for some people, lung function declines rapidly regardless. These people are sometimes referred to as "rapid decliners."

Factors Contributing to Rapid Lung Function Decline

According to the American Journal of Respiratory and Critical Care Medicine, if your lung function declines more rapidly than it does in 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 female
  • Being of African American descent

Why Quit Smoking?

Research published in the European Respiratory Journal suggests that smoking cessation improves COPD symptoms, reduces airway hyperresponsiveness, and "normalizes the excessive FEV1 decline in all stages of the disease." FEV1 is a measurement of the amount of air that people can forcefully blow out of their lungs in one second, and it’s an important indicator of health status for people with COPD, showing lung capacity.

 Quitting also improves survival in people with COPD.

Additional research has found that in those who quit smoking, there is a significant reduction in lung function decline, compared with those who continue to smoke. In fact, those who quit smoking in the study 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, which was half that of the "continuing smokers" group (62 milliliters per year). These differences increased progressively year after year during the study's follow-up period of 11 years. At the 11-year mark, 38 percent of those who continued to smoke had a FEV1 of less than 60 percent of the predicted normal value compared with 10 percent of the sustained quitters.

How to Quit Smoking

Smoking is an addiction and should be treated that way. Using an all-encompassing approach to quitting that includes medications, counseling, meditationrelaxation, support groupsproper nutrition, and daily exercise usually works best. In addition, many find that the 12 Steps of  Nicotine Anonymous, a program that's based on spiritual principles, helps them succeed.

There are a lot of reasons why people with COPD struggle to quit smoking.

If you have tried to quit and were 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. 

Other Ways to Preserve Lung Function

Some factors that influence your lung function—such as your age, gender, and race—are obviously outside your control. But there are things that you can do to slow down that decline, besides quitting smoking. These are some extra ways to help preserve your lung function:

  • Eat a diet that's high in antioxidants. A healthy diet that's rich in antioxidant vitamins like A, C, E, and selenium may be associated with better lung function and higher levels of FEV1.
  • Avoid long-term exposure to indoor and outdoor air pollution. This means creating a smoke-free environment in your home, avoiding exposure to wood-burning stoves, biomass fuels, or harsh chemicals, and staying indoors on days when outdoor air quality is poor.
  • Exercise daily. Research suggests that a moderate to high level of regular physical activity is associated with a reduced level of lung function decline and risk of COPD in smokers. 

Sources:

Judith Garcia-Aymerich1 et, al. Regular Physical Activity Modifies Smoking-related Lung Function Decline and Reduces Risk of Chronic Obstructive Pulmonary Disease; A Population-based Cohort Study. Vol 175. pp. 458-463, (2007).

Néstor A Molfino. Genetic predisposition to accelerated decline of lung function in COPD. Int J Chron Obstruct Pulmon Dis. 2007 June; 2(2): 117–119.

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