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3. Take the Quiz on Smoking

Medical Author:

Michael C. Fishbein, MD

Michael C. Fishbein, MD

Dr. Fishbein received his undergraduate and medical degrees from the University of Illinois. He completed a residency in anatomic and clinical pathology at Harbor General Hospital/UCLA Medical Center. He is board certified in anatomic and clinical pathology.

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Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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In this Article

• Smoker's lung introduction
• What is the structure of the normal lung?
• What processes determine normal function of the lung?
• What are the abnormalities (diseases) in smoker's lung?
• What happens to the lung in emphysema?
• How does emphysema come about?
• Why does smoker's lung look black?
• What happens to the airways in chronic bronchitis?
• Are smokers with COPD predisposed to developing pneumonia?
• What about lung cancer in smokers?
• Are any of the pulmonary consequences of smoking reversible?
• From what do smokers die?
• Patient Comments: Smokers' Lung - COPD
• Smoker's Lung: Pathology Photo Essay Index

The major abnormalities in smoker's lung are grouped under the label of chronic obstructive pulmonary disease (COPD). It is estimated that 40 million people worldwide suffer from COPD. COPD is the 4th leading cause of death in the USA. Even more disturbing is the fact that COPD is the only one of the "top 5" causes of death to increase in the past decade. While COPD has been thought of as a disease of men, it is estimated that by the year 2010 there will be more women than men affected by COPD. These statistics are especially sad because COPD is preventable disease by stopping smoking; unfortunately, this is easier said than done. About 70% of smokers want to quit, but only 7% who try are smoke free after one year; however, one should not give up. Numerous tries, sometimes more than 10, and professional help often are needed, but the health benefits of smoking cessation make it worth the effort.

COPD is made up of two major, related diseases. One, emphysema, involves the lung alveoli, and the other, chronic bronchitis, involves the bronchial airway. (Both conditions are discussed below.) In this essay, I will use the term chronic bronchitis to include chronic bronchiolitis and chronic respiratory bronchiolitis. I do this because these three conditions have the same pathology (structural abnormalities), cause the same symptoms, and differ only in their location in the airway. At any rate, some smokers primarily have emphysema and some primarily have chronic bronchitis. Most, however, have a combination of these two diseases.