Why Tennessee has a high rate of COPD

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More than 500,000 Tennesseans have chronic obstructive pulmonary disease (COPD), the progressive lung disease that includes chronic bronchitis and emphysema. Tennessee has one of the highest incidences of COPD in the country. Only Alabama, Kentucky and West Virginia have higher rates of COPD.

WellTuned spoke with Ian Bushell, a family medicine physician and medical director at BlueCross BlueShield of Tennessee, about why so many people in Tennessee have this lung disease—and how you can avoid developing it yourself.

Why is COPD so prevalent in Tennessee?

Dr. Bushell: Why do we have so many people in our state with COPD? One word: cigarettes. The high incidence of this lung disorder correlates directly with a high rate of smoking. As of 2019, nearly 1 in 5 Tennesseans smoke. There are other reasons that we have a lot of COPD, including the prevalence of mining and other occupational exposures that raise the risk, but it really does largely depend on smoking.

How smoking leads to COPD

Dr. Bushell: When you smoke, the smoke that you inhale immediately works to affect how you breathe. The smoke paralyzes the little hair cells in your lungs that help to filter out dust and particles and help you clear your lungs when you cough. When those hair cells don’t work, it’s harder to clear your lungs. Over time, this increases your risk for developing scarring in your lungs—and getting infections. This results in the chronic cough and shortness of breath that’s associated with COPD.

How to treat and prevent COPD

Dr. Bushell: COPD is not curable, but it’s treatable. Your doctor can recommend medication that you use with an inhaler to help you control your symptoms and slow the progression of the disease. You might also need supplemental oxygen to help your lungs get the oxygen they need when they can’t do it by themselves. This will help you feel better and live longer.

However, it’s always better to prevent COPD from occurring in the first place. And the best way to prevent COPD is to never smoke.

If you do smoke and you don’t have COPD, you are putting yourself at risk for COPD. Quitting smoking can reduce your risk, but it’s challenging for most people. So, you may need some support to accomplish that goal. One option is calling the Tennessee Tobacco Quitline at 1-800-QUIT-NOW (1-800-784-8669). BlueCross BlueShield of Tennessee members have the opportunity to consult with a smoking cessation coach to help navigate the process of quitting.

WellTuned guide to COPD

What else you can do

Dr. Bushell: In addition to not smoking, there are other steps that you can take to stay as healthy as possible with COPD.

Exercise. If you already exercise, keep it up. If you don’t exercise, it’s time to start. But you should see your doctor first before you start any new physical activity. Your doctor may recommend starting with pulmonary rehabilitation. Pulmonary rehabilitation is a supervised program that’s regularly prescribed to help people with COPD improve their lung function, get stronger and maintain their independence. The key components are education and exercise.  Pulmonary rehab has even been shown to reduce your chances of hospitalization.

Get vaccinated. Vaccinations can help protect you from contracting a virus that could cause an illness with potentially serious complications. If you have COPD—or even if you’re just at risk for COPD—make it a priority to get these vaccines:

  • Seasonal flu vaccine. Make it an annual event for you, since you’re more likely to experience complications from the flu.
  • Pneumococcal vaccine. The CDC also recommends that adults with chronic lung disease get a pneumococcal vaccine once before age 65 or twice if you’re over 65.
  • COVID-19 vaccine (or booster). Ask your doctor if they think you should opt for a specific vaccine of the options currently available.
  • Other vaccine as recommended by your doctor. This might include a shingles vaccine or a TDAP (tetanus, diphtheria, pertussis) vaccine.

Be mindful of your symptoms

“If you have a lung disease that causes symptoms like shortness of breath or coughing, you may experience flare-ups from time to time,” says Dr. Bushell. “As a general rule, you should seek medical attention if your symptoms become worse than usual, if you cough up green or yellow mucus or develop a fever, which can be signs of infection.”

More from Dr. Bushell on WellTuned.

Jennifer Larson

Jennifer Larson is Nashville-based writer and editor with nearly 20 years of experience. She specializes in health care and family issues.

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Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.