WATCH NOW: What's Killing the River Valley? Smoking and other chronic lung diseases - Winona Daily News
If you smoke, you're hurting your body. That much we know. But did you know that just being around someone who smoked today is causing you bodily harm?
Smoking is a leading cause of death in America. But it often gets slated as other things, medically speaking. Deaths may be attributed to COPD, asthma or even diabetes — which are exacerbated by, or caused by, smoking.
"If you don't smoke, you're already doing the No. 1 thing you could do to not get one of these horrible diseases — preventable, but horrible diseases. The second thing you can do is to not be exposed to second-hand or third-hand smoke," said Todd Mahr, a Gundersen Health System allergist, immunologist and expert on the harmfulness of smoking.
Second-hand smoke might entail being in a car with somebody who was smoking. Third-hand smoke means you've been around somebody who has smoked.
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"Third-hand is more of a problem for younger kids. We talk more about third-hand smoke with parents who say, 'I never smoke around them,' but smoke is basically on their sweaters and all around them. It's still harmful," Mahr said.
Not being exposed to smoke is the one thing you can do, right now, to increase life expectancy, Mahr said.
"Some people don't think of vaping or E-cigarettes as smoking," he said. "It's good to make sure you differentiate, and not differentiate. People say, 'I'm vaping. All I'm doing is inhaling water vapor.' It's like 'No, you're not.' It's 1,000 chemicals. They can cause cancer, too."
This story is part of a River Valley Media Group series examining the leading causes of death from 1999-2020. The data within this story comes from the Center for Disease Control and Prevention.
Fourth leading cause of death locally
Chronic lower respiratory disease (CLRD) encompasses chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, as well as asthma, pulmonary hypertension and occupational lung diseases.
It is the sixth leading cause of death in the U.S., per 2020 CDC data, leading to 152,657 fatalities.
In the River Valley Region, 4,116 people died from CLRD in 2020, making it the fourth leading cause of death, in La Crosse, Vernon, Dunn, Trempealeau, Chippewa and Monroe counties in Wisconsin, and Houston and Winona counties in Minnesota, for that year.
COPD makes up the vast majority of chronic lower respiratory diseases, and is primarily caused by smoking, in around 85% of cases.
Exposure to the irritants in cigarette smoke will, over time, weaken the ability of the lungs to protect from infection and cause air tubes to swell and destroy alveoli, or air sacs.
Prolonged exposure to air pollution, fumes, chemicals or second-hand smoke can also contribute to the development of COPD, with vaping and marijuana smoking also being potential factors.
Symptoms of COPD include shortness of breath, wheezing or a chronic cough.
COPD dropped from the fourth leading cause of U.S. deaths in 2018 to sixth in 2020, but rates of the disease may be higher than believed.
According to a 2013 study, more than 50% of adults with low pulmonary function were not aware that they had COPD.
"We believe there may be underreporting, as sometimes COPD may be identified as a contributing cause of death, rather than the actual cause of death," said Dr. Hafiz Fakih, pulmonary and critical care specialist at Gundersen Health System.
Deadly consequences
Smoking is bad. But how bad?
"The biggest thing is that smoking causes everything. We're talking about lower respiratory diseases, but it causes a lot of disease and disability, and really actually harms every organ in the body," Mahr said.
Most Americans are aware that smoking greatly impacts the lungs, but it does more than that. It affects a person's entire body, Mahr said.
As longtime asthma expert with Gundersen Health System, Dr. Todd Mahr has seen the negative effects that smoking has on his patients, including death.
"Sixteen million Americans are living with diseases caused by smoking. Everybody thinks of lung cancer and COPD. It's not just lung cancer, but heart disease, stroke, other lung diseases, diabetes, emphysema, chronic bronchitis — all caused by, or exacerbated by, smoking," he said. "It also increases risk for tuberculosis, eye diseases. It just causes havoc for our immune system. From a medical standpoint, it can impact everything. In terms of COVID, it also increases risk there."
Smoking has dropped significantly in recent years, from 20.9% in 2005 to 12.5% in 2020 for adults, and from 23% in 2000 to 2.3% in 2021 for youth.
While COPD deaths among men have declined, "Rates among women have become slightly higher in COPD mortality deaths," Fakih says, with smoking rates among females declining at a slower pace than that of males.
Race is also a factor in smoking rates — among American Indians and Alaska Natives, 21.9% smoke, and 16.8% of African American and Black individuals smoke. Non-Hispanic white smokers have only a slightly lower rate at 16.6%, but they only use menthol cigarettes at a third the rate of Black smokers. Menthol products make smoking more palatable and harder to quit.
"We can manage it, but we cannot reverse it," Fakih says. "When you stop smoking, the damage ends there and then."
COVID-19 has increased awareness about lung diseases. Now that folks are not masking daily, it's becoming all too clear that there are no easy answers to how to quell lung infections and chronic disorders, Mahr said.
"It all depends on your own personal risk factors. It's not real common for people to get lower respiratory diseases, which most people would think relate to community acquired pneumonia and bronchitis. But it's still deadly. Look at the stats. A lot of people are dying here," Mahr said. "One of the things that we know that puts you at an increased risk of disease and death is smoking. People should know this. Stop if you can. There are resources available to help you do so."
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