Findings on black smokers startle researchers

PHILADELPHIA (AP) -- Black smokers who suffer from a disease that slowly robs them of breath appear to get sicker faster than whites who took up the habit earlier and smoked more, says a study by researchers at Temple University.
Researchers looked at 160 people referred to Temple's lung clinic with chronic obstructive pulmonary disease, or COPD, an umbrella term for lung damage caused by two respiratory illnesses -- chronic bronchitis and emphysema. The group was split evenly among blacks and whites, and men and women, and all had what was classified as "moderate to severe" COPD.
The study found that on average, the black smokers with COPD started smoking later in life and smoked less overall, yet they developed the disease at a younger age. The study appears in the current issue of the journal Chest.
"The findings were somewhat surprising because COPD has been seen as a disease of whites," said the study's lead author, Dr. Wissam M. Chatila of the Temple University School of Medicine.
"Traditionally, the prevalence and mortality rates have been higher in whites than blacks."
COPD is the nation's No. 4 killer, claiming the lives of more than 123,000 Americans in 2001, said the U.S. Centers for Disease Control and Prevention. Smoking causes up to 90 percent of cases, but other risk factors include exposure to occupational chemicals and pollutants, as well as genetic components.
"The real finding here, and it's going to need lots of confirmation, is that cigarettes seem to have a greater deleterious effect on blacks," said Dr. Norman H. Edelman, a consultant for scientific affairs at the American Lung Association. "That is not only important for the health of blacks, it's important with respect to the whole issue of individual susceptibility to disease."
Discovering why one person is more prone than another to certain disease -- like why one lifetime pack-a-day smoker gets cancer and another doesn't -- would have profound effects on diagnosis, treatment and prevention, Edelman said.
Many are unaware
The American Lung Association estimates that half of the 32 million people thought to have COPD don't know it. Most patients aren't diagnosed until they've lost so much of their lung function that they get winded after just a few steps.
Healthy lungs work like balloons, inflating to take in oxygen and deflating to remove carbon dioxide. COPD slowly diminishes the lungs' elasticity until they can't deflate fully.
As their disease progresses, COPD sufferers need deeper and deeper breaths to get fresh air -- and stale air can't be expelled from their stretched-out lungs.
Medication and breathing exercises can help symptoms, but the lung damage from COPD is irreversible. Lung transplants and lung-reduction surgery are far less common options.
The next step for researchers is to study a larger group of COPD patients nationwide and try to determine the reasons for the apparent racial difference, Dr. Chatila said.
"This research does not address the [question] why," he said. "We don't know whether it has something to do with health-care access, biological or genetic differences, or environmental issues."