The longer and more frequently you smoke, the higher your chances of developing emphysema.

It’s well known that smoking can have a widespread impact on your body. While most people think of just breathing conditions, the truth is that routinely smoking can increase your chances of everything from developing cancer to even having back problems, diabetes, and skin conditions.

For many people, questions around emphysema (a companion condition within chronic obstructive pulmonary disease [COPD]), another respiratory condition linked with smoking, are likely to come up the longer you smoke.

Most experts will say that smoking contributes to emphysema rather than being a direct cause. As with many respiratory illnesses linked with smoking, it can be difficult to determine an exact cause, but emphysema is one that can develop as a result of smoking.

Physical damage sustained by your lungs as a result of exposure to tobacco smoke — or the toxins released in tobacco products — is what encourages emphysema to develop. That’s why people who work in dangerous settings (such as miners) are also more likely to develop emphysema because of constant exposure to polluted air.

Specifically, the chemicals and particles released in the smoke lead to irritation, which progresses into inflammation. In particular, the thin walls of the alveoli in your lungs are most affected by this phenomenon and are eventually destroyed with sustained exposure.

As a result, the exchange of oxygen and carbon dioxide that normally occurs becomes less effective, leading to poor breathing — a hallmark of emphysema.

The stats on emphysema

According to the Centers for Disease Control and Prevention (CDC), men who smoke are 17 times more likely to die from emphysema than nonsmokers. Meanwhile, women who smoke are 12 times as likely to die from the respiratory disease.

Typically, emphysema is included in the cluster of diseases associated with COPD, with individual statistics for deaths from emphysema included in total COPD mortality numbers. According to a Surgeon General’s report from 2014, between 2005 and 2009, a total of 100,600 people died from COPD: 50,400 men and 50,200 women.

However, according to the National Vital Statistics System, in 2021 there were officially 7,336 deaths directly attributed to emphysema.

Language matters

You’ll notice that the language used to share stats and other data points is pretty binary, fluctuating between the use of “male” and “female” or “men” and “women.”

Although we typically avoid language like this, specificity is key when reporting on research participants and clinical findings.

Unfortunately, the studies and surveys referenced in this article didn’t report data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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Is it just cigarette smoke?

While most people focus on cigarette smoke, vaping has been linked to popcorn lung, which causes scarification and damage to the lung tissue. Likewise, smoking cannabis can also contribute to emphysema.

In fact, smoking cannabis may even deposit more tar in the lungs that tobacco smoking.

Typically, the more a person smokes, the more likely they are to develop emphysema. Likewise, sustained smoking can shift them into higher disease progression.

A 2015 study that reviewed responses from a 2012 survey looked at the incidence of COPD in adults who were 45 years of age or older. The study compared that against their respiratory histories. In total, the study looked at 4,135 adults with a smoking history

In particular, researchers reviewed smoking history, respiratory symptoms, if cessation occurred, and how long a person smoked. Smokers were segmented into three groups: people who smoked for 1–9 years, 20–29 years, and 30 or more years.

Of the original group, 1,454 participants had smoked for 30 or more years, with nearly half of that group being current smokers. This group also had the highest incidence of COPD. Meanwhile, people who had stopped smoking at least 10 years earlier had a lower rate of COPD compared with people who still smoked.

The findings concluded that the more a person smoked, the more likely they were to develop respiratory symptoms (frequent productive cough, frequent shortness of breath, and poor physical activity because of smoking). The study also noted that women had a higher prevalence of COPD across all of the smoking duration groups.

You can’t reverse lung damage caused by smoking — or from other causes.

But, choosing to quit smoking can prevent future damage from occurring, or progressing. This means that any deterioration that has occurred is slowed significantly. This can lead to a better quality of life, improvement in lung function, and a reduction in any potential symptoms if you currently have emphysema or other COPD-related diseases.

Although the disease can’t be reversed, symptoms can be lessened by committing to quit smoking. According to the American Lung Association, within 1–9 months after quitting, cough and shortness of breath (two main COPD and emphysema symptoms) are greatly reduced.

Your overall expectancy depends on when you’re diagnosed, your current stage, and if you continue to smoke. Because emphysema is a progressive degenerative disease, if you continue to smoke, your outlook will progressively get worse.

There are four stages in total, with stage 1 being the least debilitating and stage 4 being the most severe. A person — even if they smoke — with stage 1 emphysema or COPD will potentially only lose 1 or 2 years from their life expectancy. But, smoking will most likely shift that individual into more severe stages thanks to sustained lung tissue damage.

Meanwhile, stage 3 emphysema or COPD can reduce life expectancy by as much as 6 years. Finally, stage 4 is the most severe form and can see a person lose as much as 9 years from their lives. Although some people can survive with stage 4 emphysema for extended periods, few active smokers can achieve that goal.

Get help to quit smoking now

While smoking cessation can’t reverse emphysema and COPD damage, it can greatly lessen the effects and reduce disease progression.

Going “cold turkey” may work for some people, but others may have more success with a smoking cessation program. The federal government, independent health organizations, and state and local governments provide resources to help people quit smoking safely.

When you’re ready to start changing your relationship with tobacco, you can check out:

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Emphysema and other COPD-related conditions are well known to be connected to smoking, especially regular or daily smoking. The different chemicals in cigarette smoke cause physical damage to the lungs and can reduce breathing abilities.

While emphysema can’t be reversed, quitting smoking can reduce common symptoms such coughing and shortness of breath.