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Quit smoking now.. and you can still enjoy some good life–enjoy-good-life.html?ito=feeds-newsxml

Quit smoking now.. and you can still enjoy some good life

By Dr Ellie Cannon

PUBLISHED:22:20 GMT, 23 February 2013| UPDATED:22:20 GMT, 23 February 2013

Good's bad habit: Richard Briers as Tom Good

Good’s bad habit: Richard Briers as Tom Good

Richard Briers loved a ‘laugh and a joke’ – or smoke, for those not fluent in cockney rhyming slang.

In an interview before his death last week at 79, Briers – a national treasure for his role in TV’s The Good Life – estimated his nicotine habit had seen him puff half a million cigarettes in his life.

Despite having given up a decade ago, it was too late: he spent the last years of his life too breathless to manage climbing stairs, thanks to lung disease.

‘I’ve got emphysema, you see, so I’m b******d,’ he said, as wryly as his alter ego Tom Good might have done.

‘The ciggies got me. If you do it [quit] in your 30s, you’re OK, but after 30 it gets you.’

He was right in many ways, but he probably enjoyed a far better final decade because he DID stop smoking.

It’s testament to the horrific grip of addiction that I have patients who, given a diagnosis like this, carry on smoking.

Richard’s apparent symptoms were not the worst I’ve seen – many patients spend their final years immobile and bound to an oxygen cylinder, unable to speak. For those who ask the kind of questions below about smoking, my message is: It is never too late: quit now!

So smoking doesn’t just mean you get lung cancer?
No. Most people realise lung cancer and smoking go hand in hand, but less well known is the link with other lung diseases.

Emphysema is now generally referred to under the umbrella term chronic obstructive pulmonary disease or COPD – which also includes chronic bronchitis – that causes horrific symptoms and is ultimately also fatal.


Both involve narrowing of the airways in the lungs and a debilitating, life-threatening and progressive condition that interferes with normal breathing. Smoking irritates and inflames the lungs, resulting in scarring. Over years, the inflammation leads to changes in the lung. COPD is the fifth biggest killer in the UK.

If Briers was ‘b******d’ anyway, why bother to quit?
By stopping smoking, he would have helped to relieve some of his symptoms of breathlessness. Once emphysema is at a certain stage, it is classified terminal. Giving up smoking, no matter what stage of the disease, can prevent it from worsening and for those with early emphysema, stopping can be the only treatment they may need.

Emphysema is not the end: Giving up smoking, no matter what stage of the disease, can prevent it from worsening and may mean you don't need treatment

Emphysema is not the end: Giving up smoking, no matter what stage of the disease, can prevent it from worsening and may mean you don’t need treatment

How come some get to their 80s having smoked all their life and have no lung problems?
Of all smokers who get through 20 cigarettes a day, about 20 per cent will develop COPD. As yet, no reason has been identified why some smokers will develop the lung disease while others won’t.

Likewise, roughly one in ten lifetime smokers of 40 a day will develop lung cancer if they continue past the age of 60, but it’s impossible to know which.

I wouldn’t like to live with those odds. The risks increase with every year that smoking continues and can reduce or at least not increase if the person quits.

What are the signs and symptoms of COPD?

Do it: It's never too late to quit smoking

Do it: It’s never too late to quit smoking

Coughing tends to be the first: normally an intermittent ‘smoker’s cough’ which then becomes persistent and regular.

Breathlessness and producing a lot of phlegm each day are other features that signal damaged airways. These all start off mild but evolve into daily, distressing symptoms.

Patients with terminal COPD are often housebound due to breathlessness. They need to be attached to oxygen most of the day and quality of life is poor. Since the airways are so badly damaged, infections are very common and they are more prone to pneumonia.

Can it be cured?
There is a range of treatments, depending on severity, but none can reverse the lung damage.

Inhalers are a common treatment, as are steroids and tablets to break up the mucus or open up the airways. Oxygen therapy is prescribed in the late stages and lung surgery may be an option for some with certain types of COPD.

This may involve removing a section of the lung that’s no longer working, called lung volume reduction surgery (LVRS), to give the remaining lung more room to work.

But one in four gets no benefit, and about one person in 20 dies during or shortly after surgery. Sufferers can also help themselves by losing weight, exercising and having flu and pneumonia vaccines

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