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COPD and Smoker’s Guilt

COPD Basics

October 23, 2023

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Photography by Stefania Pelfini/Getty Image

Photography by Stefania Pelfini/Getty Image

by Marcia Frost

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Medically Reviewed by:

Thomas Johnson, PA-C

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by Marcia Frost

•••••

Medically Reviewed by:

Thomas Johnson, PA-C

•••••

•••••

It feels terrible when people tell you to stop smoking because you might get chronic obstructive pulmonary disease (COPD). Imagine if you already had it. 

The guilt is everywhere. If you turn on the television or look at billboards on the road, you’ll see ads for quitting smoking. Some friends and family, and even strangers, blatantly shame people for smoking.

You may smoke, you may have quit smoking, or you may never have smoked at all. Anyone can get COPD — even nonsmokers. In my case, 20 years passed between my last cigarette and my diagnosis. But smoker’s guilt is real and if you have it, it’s probably time to let it go and focus on taking care of your health.

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My story

I’m embarrassed to say I started smoking when I was 12 years old. It was the early 70s, and all the “cool kids” in my junior high were doing it. Cigarettes were only 50 cents a pack, and it didn’t eat into too much of my babysitting money.

The fact that I had asthma didn’t deter me. Even activities, such as horseback riding and gymnastics, didn’t keep me from cigarettes.

The only time I accepted that I shouldn’t smoke was 11 years later when I was pregnant with my daughter. I quit at that time.

The one time I felt guilty about smoking was when she developed asthma (yes, I had started smoking again soon after she was born).

I finally decided to quit 25 years after I started. I cut down very slowly: Twenty cigarettes a day, 19 a day, 18 a day… It took me months to get down to a few a week.

My grandfather passed away of natural causes. He was 93, but we were close, and it was hard on my small family. In the car on the way home, my daughter, whose birthday was the following day, looked at me and said she wanted me to quit smoking so she wouldn’t have to bury me soon. That’s what she wanted most for her birthday.

I went home and threw out the rest of the cigarettes. I was down to one or two a week, and it wasn’t that hard.

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My diagnosis

At some point, I read an article that said that 20 years after you quit smoking, your lungs are back to pre-smoker status. I can tell you that’s not always true.

I’d just found out I had lupus. It was 2015, and I was suddenly sun sensitive, getting rashes, and short of breath a lot. My rheumatologist wasn’t sure if it was related to the lupus or something else. He sent me to a pulmonologist, who did an X-ray. He thought he saw something, so he ordered a CT scan.

The results showed that I had COPD, specifically emphysema.

I was in shock. It had been 20 years since I quit smoking, so I thought I was supposed to be back to “normal” lungs. I’d had bronchitis often through the years, so there had often been chest X-rays. They were all clear until this one.

My first question to my pulmonologist was, “How can I get COPD so many years after quitting smoking?” He looked at me and said, “The effects of smoking never go away. Smoking caused this.”

Dealing with the guilt

My pulmonologist was not very helpful. He brought up my smoking at every visit and wasn’t too anxious to offer me options to feel better. I decided it was time to get another doctor.

The next pulmonologist I found, who I still have now, was completely different. He wasn’t concerned with how I got emphysema. Instead, he was set on finding medications to make me feel better.

He first set me up for a host of tests to get baselines on my breathing capacity. The results were not bad, but I was still getting out of breath doing simple things such as getting dressed or walking across the house.

I began prednisone for some immediate relief to my breathing. He explained that I might always need it, but hopefully, we would be able to keep the dose low and just do short stints of higher doses when I have flares or bouts of bronchitis or pneumonia.

We tried four different inhalers until I found the one that worked best for me (Breztri). The pulmonologist explained to me that there is no one medication that works for COPD. It’s trial and error, trying different combinations until something helps.

Although my new pulmonologist didn’t bring up my former smoking, I still couldn’t help but feel I did this to myself.

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My secret

I am very open with my friends and family and write about my health issues often. I have multiple autoimmune and connective tissue diseases. I talk about my treatments and progression and when I feel good.

Despite all that, very few people know I have COPD.

This is the first time I am writing about it.

It’s so hard to get past the smoker’s guilt. The commercials on television are constantly pointing to the problems caused by smokers, affecting not just them but also their families.

I have been afraid of being judged.

No one is going to judge me for having lupus or Ehlers-Danlos syndrome. You can’t give those to yourself, but you can give yourself COPD.

As I started to do more research, I realized there are many people with COPD who have never smoked. You can get it from air pollution or exposure to coal. You may get it from secondhand smoke and not necessarily from family members.

For years, people were allowed to smoke in public, even in enclosed areas such as airplanes. If you frequented those places, you may have gotten COPD there.

Moving past it

It has been 7 years since I found out I have COPD. In that time, I also found out I have interstitial lung disease and three other chronic illnesses. I don’t have time to worry about what happened in the past. I need to worry about keeping myself healthy in the present.

The fact is that you cannot go backward. You can’t change anything you did, whether it was a year ago or 20 years ago. All we can do is what’s best for our health in the here and now.

Join me in the Bezzy COPD community and share your thoughts on dealing with COPD.

Medically reviewed on October 23, 2023


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About the author

Marcia Frost

Marcia Frost covers travel and health for online, print, and television. She is learning her limitations as she battles multiple progressive illnesses, including COPD, Dermatomyositis, Ehlers-Danlos Syndrome, and UCTD. You can follow her on Twitter, Facebook, Threads, Instagram, and YouTube.

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