Women face a significantly increased risk of smoking-related lung disease. American Joan Cousins belonged to a generation of young women who heard and succumbed to the idea that cigarette smoking was elegant, fashionable, and even liberating. At the time, no one suspected that it would make them more equal to men if they suffered from life-shortening suffocating lung disease.
“Everyone smoked. It was cool,” said Cousins, who tried his first cigarette 67 years ago when he was 16.
But one day Cousins began to cough and could neither stop nor even take a deep breath. He went to the hospital, where doctors told him that he had a progressive lung disease called chronic obstructive pulmonary disease (COPD). “The inability to breathe was so terrible… I have never tried another cigarette,” Cousins said.
Table of Contents
Figures for lung diseases
Traditionally, COPD was considered a male disease, but now more women than men die from it in the United States. According to the American Lung Association, women make up 58% of the 14.7 million people living in the country with the condition and 53% of those who die from it. Nearly 8% of women reported a diagnosis of COPD, compared to just under 6% of men.
Former First Lady Barbara Bush, 92, suffers from the condition. A statement by a family spokesman on Monday, April 16, that Bush had decided to begin receiving “comfort care,” a type of end-of-life care, sparked debate about what it means to end treatment for a terminal illness.
“This is a huge public health issue for women that is really not getting enough attention,” says Dr. Meylan Khan, an associate professor of medicine at the University of Michigan. “This is one of the top killers of women in the country.”
Because COPD usually occurs in men, women are often diagnosed with the disease at an advanced stage. Symptoms include chronic cough, wheezing, chest tightness, and shortness of breath. There is no cure, but its progression can be slowed down. The most important thing a patient can do after being diagnosed with COPD is to stop smoking.
Historical context of smoking
Researchers mostly blame the gradual adoption of smoking by women for the increase in deaths from COPD. Men began to smoke en masse in the late 19th century, coinciding with the mass production of cigarettes. In the 1920s and 1930s, tobacco companies began targeting women with advertisements that appealed to their sense of independence and desire for social and sexual attractiveness.
Another wave of advertising campaigns in the late 1960s and early 1970s encouraged large numbers of women and teenagers to start smoking cigarettes. Brands such as Virginia Slims used the women’s liberation movement with catchy slogans including “You’ve come a long way, girl.”
“The effects of COPD persist for decades,” says Mei-Ling Wilgus, MD, an assistant professor of clinical medicine at UCLA and a pulmonologist. “We’re seeing the effects of heavy smoking on women, especially in the 1960s and 1970s.”
Why do lung diseases affect women more?
Gender differences also increase the risk of COPD for women. Studies show that women may be more susceptible to the toxic effects of cigarette smoke than men. The exact cause is not exactly known, but researchers believe one factor is that women’s lungs tend to be smaller. Estrogen can also exacerbate lung damage caused by smoking.
Cousins, who quit smoking at 62, said he now carries an oxygen tank with him everywhere. He jokingly calls him “his best friend”. At night, she sleeps connected to a machine that helps keep her airways open. Despite assisted breathing, Cousins said he often feels like someone is pressing on his chest. The 83-year-old woman, who lives southeast of San Francisco, is still capable of farming and making art, her specialty is decorating burnt wood, but she has described the illness as “slow suffocation.”
What lung diseases are considered?
COPD is a general term used to describe progressive lung diseases, including chronic bronchitis, emphysema, and other conditions that make it difficult for air to get out of the lungs. In addition to smoking, factors such as environmental pollution and genetics can also contribute to the development of the disease.
Women are more likely than men to experience respiratory crises, which can be caused by infections or exposure to pollutants. Frequent crises are associated with faster progression of the disease.
Is there a cure?
COPD treatments that can temporarily improve symptoms and lung function include bronchodilators to open the airways, inhalers and steroids, said Khan, who is also a volunteer spokesperson for the American Lung Association. In the most severe cases, a lung transplant may be required.
Doctors and advocates say many women unknowingly live with the condition because they don’t know or don’t want to seek help.
“If they’re having trouble breathing when they’re walking up the stairs, they might say, ‘I’m a little old, heavy, or out of shape,'” says Stephanie Williams, director of community programs at the COPD Foundation, who recently conducted the study. webinar on diseases among women. “Women delay treatment longer and hide their symptoms.”
Learn the story of Ines Shakman
Ines Shakman, 73, who lives in Ventura, California and is a patient of Dr. Vilgus, said she had trouble breathing for years and the common cold tended to settle in her chest and last longer than expected. It also cost him even a short walk. Just four months ago, he found out he had COPD. I have never heard of the disease. According to him, now, taking medication, he can walk around the park without stopping and without taking a breath.
Medical schools have long taught about COPD, but in books that include pictures of men with the disease, researchers have found a gender bias in medical diagnoses. In a famous study, physicians presented to hypothetical patients were more likely to correctly diagnose men than women.
Caroline Gainer, a 74-year-old retired teacher who lives in Daniels, a rural West Virginia town, has repeatedly told her doctor about her symptoms, including coughing every morning and shortness of breath. “He thought I had asthma,” he said.
Eventually, he was diagnosed with COPD and now needs oxygen to move. That was when he quit smoking with a nicotine patch after half a century of smoking. “I do everything I have to,” Gainer said. “I may not be able to stop the progression of the disease, but I can slow it down,” he said.
KHN coverage in California is partially supported California Blue Shield Foundation.
Author: Anna Gorman: @AnnaGorman
Cover photo: Anna Gorman/California Healthline
Photo Description: Inez Shakman lives in Ventura, California and was recently diagnosed with chronic obstructive pulmonary disease (COPD). She walks her dog Joy whenever she can, but she easily gets short of breath. (Anna Gorman/California Healthline)
KFF Health News is a national news outlet that produces in-depth journalism on health issues. Along with policy analysis and reviews, KFF Health News is one of the three main operating programs of the KFF (Kaiser Family Foundation). KFF is a non-profit organization providing health information to the nation.