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ENGLISH
singer Amy Winehouse is no stranger to tabloid
headlines—routinely grabbing attention for alleged drug
use, brushes with the law, bizarre on-stage behavior and
curious fashion choices. Yet, a recent disclosure that
the 24-year-old has “signs of emphysema,” according to
her US publicist, Tracey Miller, shocked many. Though
copious photos show the beehived songstress with a
cigarette dangling from her lips, it seemed stunning to
learn that someone that age could suffer from a disease
usually associated with two-pack-a-day 65-year-olds.
But
Winehouse is not an anomaly. Health experts say that
young adult smokers are no strangers to mild emphysema,
a shortness of breath caused by damage to the lung’s
small air sacs. Smoking can permanently deteriorate the
lungs, irreversibly diminishing lung capacity—and the
damage starts young, even in teens who smoke five
cigarettes a day, according to one 1996 study from the
Harvard School of Public Health and the Brigham and
Women’s Hospital in Boston of 10,000 youths who smoked.
“Teenagers and people in their 20s think they’re
invincible,” said Dr. Norman Edelman, chief medical
officer for the American Lung Association. “They think
they can wait until they’re 35 to stop smoking and
everything’s going to be fine, but they can do permanent
damage before that.”
The
damage can come in the form of emphysema, which is
caused by some of the 4,000 to 5,000 toxic chemicals in
cigarette smoke. (None in particular is known to be the
source of the damage, but collectively they create chaos
in the lungs.) Activated oxygen molecules in the smoke
trigger inflammation that can’t be controlled, said Dr.
Jonathan Samet, chairman of the epidemiology department
at the Johns Hopkins Bloomberg School of Public Health
in Baltimore.
Even in
early stages of emphysema (defined generally, Samet
said, as having less than 80 percent lung function), the
chemicals are breaking down the lung’s tiny air sacs,
called alveoli. The consequence: “A grape-like cluster
of tiny air sacs becomes one big sac, which means there
is less area to exchange oxygen,” Edelman said.
Inflammation, Samet said, reduces the air sacs’
elasticity, making it harder for them to expand and
contract, moving air in and out. “It’s like the
difference between a balloon filled with air and a paper
bag filled with air.” As well as emphysema, Samet adds,
smoking can cause chronic bronchitis, the lung
inflammation characterized by irritation and scarring.
“There are a lot of extraordinarily irritating
substances in tobacco smoke. The lung has defense
mechanisms that can clean out things that get in. But
smokers dump so much toxic stuff in that the lungs can’t
keep up.”
Adding
illegal drugs to the mix—such as marijuana or crack
cocaine—can exacerbate the problem, although experts
aren’t sure if either directly causes emphysema. “It
basically compounds the issue,” said Dr. Zab Mosenifar,
medical director of the Women’s Guild Lung Institute at
Cedars-Sinai Medical Center in Los Angeles.
Edelman
said some of the bronchitis inflammation is reversible,
but the lung damage of emphysema is not—and continuing
to smoke results in less and less lung function over the
years. (Everyone’s lung function declines with age, but
that of smokers declines faster.)
Young
adults with mild emphysema might notice slight
physiological changes—a pickup basketball game becomes
more arduous, or lugging groceries produces a little
wheezing. A singer such as Winehouse may not be able to
hold long notes with ease.
Others—especially if they’re inactive—may not have
symptoms until later in life. “Unless you’re a marathon
runner, you’re not using your full lung capacity,”
Edelman said. “Someone living a normal life might not
feel anything, and that’s the big problem. They don’t
feel anything until they lose 40 percent to 50 percent
of their capacity.”
Winehouse isn’t the first young celeb linked to
emphysema. Model Christy Turlington disclosed in 2000 at
age 31 that she had mild emphysema, the result of a
10-year smoking habit that started when she was a
teenager (she quit in 1995). At the time, Turlington was
quoted as saying about her diagnosis, “The really
frightening thing is that there was enough of an effect
from my smoking that it caused permanent damage.” Her
father died of smoking-related lung cancer.
The good
news is that, overall, fewer young adults are smoking.
In 2006 24 percent of 18- to 24-year-olds smoked, down
from 34 percent in 1983, according to the national
Centers for Disease Control and Prevention.
Damage
can be seen via CT scans, MRIs and lung-function tests.
Quitting smoking is the best way to stave off further
lung damage. Experts say mild emphysema usually isn’t
treated with medication unless asthma is also involved.
Winehouse’s doctors, Miller said, “expect a full
recovery based on the treatment she’s going through,”
although the publicist didn’t specify what that
treatment is. Unfortunately, Winehouse doesn’t seem to
have kicked the habit yet: She was spotted lighting up
last week after leaving a London hospital.
Perhaps
others will learn from her example: “If there’s any
silver lining,” said Mosenifar, “she may have a positive
impact on young smokers....A lot of young kids think
this is Grandpa’s disease.”
Dr. Mark
Eisner, associate professor of medicine at the
University of California, San Francisco, said the
take-home message isn’t for young smokers to flock to
get lung-function tests. Rather, what they need to do is
“stop smoking,” he said. “If their lung function is
preserved, it doesn’t mean it will continue to be.” |
