COPD, tobacco, and alcohol

Chronic obstructive pulmonary disease (COPD) refers to a group of lung diseases that affect your breathing. This includes chronic bronchitis and emphysema.

People with COPD typically have blocked airways and experience breathing-related problems. These problems result from reduced functional lung capacity along with lung inflammation and damage.

Some people with COPD also experience excessive mucus production, which can make breathing difficult.

COPD is very common in people who smoke. But there’s another factor that complicates the condition.

People who smoke also frequently drink. That makes understanding the relationship between drinking, smoking, and COPD hard to pin down.

There’s evidence that alcohol dependence and tobacco use are linked. But how does alcohol use connect to having COPD?

Here’s a look at how smoking and drinking can cause, and possibly complicate, this lung condition.

On drinking and smoking

The relationship between drinking alcohol and smoking is well established.

According to the National Institutes on Alcohol Abuse and Alcoholism, people with alcohol dependence are three times more likely to be smokers than the average population.

Similarly, people who are chronic tobacco users are four times more likely to be dependent on alcohol than the average population.

On smoking and COPD

COPD is typically caused by long-term exposure to lung irritants, which can damage your lungs and airways. In the United States, inhaling cigarette smoke is considered to be the number one cause of COPD.

Pipe, cigar, and other types of smoke — secondhand or environmental — can also cause COPD.

According to the Centers for Disease Control and Prevention (CDC), 15 million Americans are currently diagnosed with COPD.

Of those 15 million, 39 percent still smoke, despite the obvious relationship between smoking and lung diseases.

On drinking and COPD

Drinking regularly may increase your risk of developing COPD.

According to some researchers, heavy drinking reduces your levels of glutathione. This antioxidant helps protect your lungs against damage from smoke.

Additionally, regular or chronic drinking prevents your lungs from keeping up a healthy airway. Your mucociliary transport system works continually to clear mucus and contaminants out of your airways. When you drink heavily, the system doesn’t work as effectively as it should.

One-third of adults with chronic health problems, including COPD, reported that they drink regularly. Of those, nearly 7 percent reported drinking heavily.

A 2016 study indicates that being diagnosed with a medical condition or beginning treatment for a serious disease, like cancer, often prompts some adults to quit drinking.

But that’s not the case for many people with COPD.

The same study found that people diagnosed with COPD, as well as other cardiovascular disorders, aren’t as likely to give up drinking because of the diagnosis.

This suggests that many people with COPD regularly drank before being diagnosed with COPD. With this in mind, it’s hard to determine whether their alcohol consumption contributed to their diagnosis.

Smoking is almost always the cause of COPD. Nearly 90 percent of all COPD cases are caused by cigarette smoking.

In fact, smoking ultimately accounts for as many as 8 in 10 COPD-related deaths.

Still, 1 in 4 Americans with the disease have never smoked. Other causes also contribute to who develops the condition.

These include:

  • exposure to secondhand smoke
  • exposure to environmental toxins and pollution
  • exposure to fumes from burning chemicals or fuel
  • certain genetic disorders, such as alpha-1 antitrypsin deficiency

If you’re experiencing trouble breathing and you drink alcohol regularly, see your doctor.

This may be a sign of an underlying medical condition, such as COPD. In people with asthma, alcohol can trigger an asthma attack.

If the only time you develop breathing problems is after drinking alcohol, you should still see your doctor. You may have a rare allergy to the ingredients found in wine, beer, or spirits.

In its earliest stages, COPD may cause no symptoms at all. The earliest symptoms of the condition are often mild.

These include:

  • shortness of breath
  • difficulty regaining breath during physical activity
  • chronic cough
  • chest tightness
  • a whistling sound when breathing, or wheezing

As the condition worsens, the symptoms will worsen, too.

Symptoms of advanced COPD include:

  • blue or gray fingernails, which are a sign of low oxygen in your blood
  • rapid heartbeat
  • difficulty catching your breath or talking, even without physical activity
  • changes in mental alertness
  • weight loss
  • swelling in your ankles and feet

If you haven’t seen your doctor in a while or if you develop suspicious symptoms before your next visit, make an appointment.

Symptoms may not be obvious until the condition is advanced. That’s why getting a diagnosis and beginning treatment as soon as you can are vital.

Diagnosing COPD requires a physical exam, a review of your medical history, and some tests.

First, your doctor will review any signs or symptoms you’re experiencing. Be honest about how often you drink and smoke. If you’ve quit drinking or smoking, let your doctor know how long ago you quit and how much you used to drink or smoke in the past.

Tell your doctor about any family history of related conditions, including lung cancer, COPD, asthma, or other breathing problems.

To confirm a COPD diagnosis, your doctor will likely order one of several tests. These include:

  • Lung (pulmonary) function test: This test measures how much air you can inhale and how much you exhale.
  • CT scan: This imaging exam can rule out other possible causes for your symptoms. It can also help detect certain lung issues, such as emphysema and lung cancer.
  • Chest X-ray: This imaging test can help detect possible causes, including pneumonia and other conditions of the heart and lungs.
  • Arterial blood gas analysis: This test is a measure of how well your lungs are taking oxygen in and moving carbon dioxide out.

If you’re diagnosed with COPD and continue to drink or smoke, your symptoms will likely worsen. Your best bet at slowing disease progression is to quit smoking, reduce your number of drinks, and work toward an overall healthy lifestyle.

People who use or misuse alcohol are more likely to smoke. People who smoke are more likely to drink. This combination increases your risk for several conditions and can aggravate symptoms of COPD.

If you’ve been diagnosed with COPD, quitting smoking and stopping chronic alcohol use can go a long way to reducing symptoms and helping you live a healthier life.

If you’re ready to give up smoking or cut back on drinking, these tips can help you get started:


You may think you know how to quit, but maybe you need more information.

Read, explore, and question. Each person needs different types of guidance and accountability during the process. Find a plan you think will work, and write it out.

Partner up

Getting support from another person trying to quit may not be ideal. Instead, you need an accountability partner, someone you can turn to when your resolve is waning.

This should be a person who can be tough with you but also cheer you on. Explain your plan, and decide on steps of intervention if you slip up or need additional help from outside resources.


No day is an ideal day to quit. You never know what crisis at work or home will happen. Just pick a day — any day.

Mark it on your calendar, announce it to your partner or friends, and then quit.

Throw away your cigarettes, lighter, and paraphernalia. Remove any beer, wine, or liquor from your home.

Reward yourself

Set goals, and then plan rewards for reaching those goals. After three days without a cigarette or a drink, buy yourself a new book. After a week, take yourself out for a nice dinner.

When you reach a month, look for a new piece of clothing or accessory. Reward yourself for every success, and hold yourself accountable for every setback.

Don’t give up

Many people who are successful ex-smokers or ex-drinkers had to try several times before they were able to quit in the long term. If you resume drinking or smoking, you can always quit again.

Adjust your plan, find a new coach if you need one, do what it takes to find success. It’s never too late to quit.