Some 2 million Americans have emphysema. It’s a terrible disease of slow suffocation, overwhelmingly caused by decades of smoking. Everyone knows that smoking causes the vast majority of the nation’s 160,000 annual lung cancer deaths. Most people know that smoking contributes to many of the 740,000 deaths from heart disease. But few know that emphysema and its sister condition, chronic obstructive pulmonary disease are the nation’s fourth leading cause of death, killing 106,000 Americans each year.

Deep in your lungs are 300 million tiny air sacs (alveoli), where oxygen enters the bloodstream and carbon dioxide leaves it. Your alveoli are naturally elastic. They expand when you inhale, and contract when you exhale. But the alveoli of long-time smokers lose their elasticity, and become permanently stretched. Many rupture. As a result, they can’t move oxygen and carbon dioxide in and out of the blood as they used to. People with emphysema suffer chronic oxygen starvation, and feel like they’re slowly suffocating, which they are.

Symptoms of Emphysema

The main symptom of emphysema is shortness of breath, which ofen grows worse over time. Even minor physical activity becomes a challenge. As you struggle to breathe, your chest becomes enlarged and barrel-shaped. In advanced emphysema, to get around, you may need an electric wheelchair, and to breathe, supplemental oxygen from a tank fitted with tubes that run into your nose. Not a pretty picture, which is one of many reasons why no one should smoke, and why every smoker should quit—now.

Causes of Emphysema

Although smoking is the overwhelming cause of emphysema, long-term exposure to dust, air pollutants, chemical vapors, and a hereditary deficiency of the enzyme that maintains the alveoli’s elasticity may also play a role.

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