English singer Amy Winehouse is no stranger to tabloid headlines -- routinely grabbing attention for her alleged drug use, brushes with the law, bizarre onstage behavior and curious fashion choices.
Yet last week's disclosure that the 24-year-old has "signs of emphysema," according to her U.S. 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, in fact, 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.
But many smokers don't show symptoms for years, leading them to believe no damage is being done when, in fact, it is accruing all the time. "Teenagers and people in their 20s think they're invincible," says Dr. Norman H. Edelman, chief medical officer for the American Lung Assn. "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 are 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, says 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 says, as having less than 80% 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 says.
Inflammation, Samet says, 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."
