The Queen had to pull out of attending the Royal Variety Performance last week, one of several engagements she has now missed due to a chest infection.
At a recent event at Buckingham Palace, the Queen revealed to actress Emily Mortimer that she had stopped smoking 20 years ago.
This begs the question: Could a history of smoking make those who have quit more susceptible to respiratory infections, and if so, what can they do to protect themselves?
Ex-smokers are more prone to all types of infections, from colds and flu to pneumonia, experts say. They are also more likely to suffer worse symptoms. “Even if your lungs are slightly damaged by smoking, you are more susceptible to infections,” says Professor Nick Hopkinson, a respiratory specialist at London’s Royal Brompton Hospital and medical director of the charity Asthma + Lung UK.
In healthy lungs, sticky mucus (sputum) traps harmful particles and bacteria, carrying them down the throat to be swallowed and destroyed. Immune cells patrol the lungs at the same time, destroying any insects. But in smokers, the lungs become inflamed and produce too much mucus. When this becomes trapped, smokers expel it.
It also causes direct damage to lung cells, making it difficult for the lungs to inflate and deflate, leading to difficulty breathing.
The Queen had to pull out of attending the Royal Variety Performance last week, one of several engagements she has now missed due to a chest infection.
Camilla smoking while traveling with the Beaufort Hunt in 1996
“Once you start to have symptoms caused by smoking (such as passing sputum, coughing and difficulty breathing), it is more likely that there is already some lung damage,” adds Professor Hopkinson.
Smoking also changes the microbiome (the community of bacteria and viruses) in the lungs.
This makes it easier for harmful insects (particularly streptococci, a leading cause of respiratory infections, particularly pneumonia) to cause further damage, explains William Cookson, professor of genomic medicine at the National Heart and Lung Institute at Imperial College London. London.
If you continue smoking, the inflammation causes progressive scarring in the airways. Smoking for ten years or more is likely to cause permanent damage, which appears to make people prone to respiratory infections, as well as increasing the risk of diseases such as lung cancer, Professor Cookson says.
If you stop smoking, lung inflammation decreases, the immune system begins to function better, the microbiome returns to normal, and although the scars remain, they do not worsen.
“However, scars can leave you vulnerable to chronic infections by harmful microbes, including Haemophilus influenzae and Streptococcus pneumoniae, which cause further damage and bouts of pneumonia, but ex-smokers do not suffer as much as regular smokers,” says Professor Cookson.
There are ways for current and former smokers to help keep chest problems at bay. “Staying active is really important – exercise helps improve lung capacity,” explains Dr John Conibear, clinical director of pulmonary oncology at Barts Health NHS Trust in London. “Even starting to sing will help improve it.”
Eating a healthy diet rich in antioxidants (berries, spinach and walnuts) and omega-3 fatty acids (oily fish and flaxseed) can improve lung health, adds Dr Conibear, who also works at the Harley Street Clinic in London. Try to avoid lung irritants, such as fumes from chemicals found in cleaning products, as they could cause further damage.
And keep in mind that it’s never too late to quit smoking. Smoking “increases the risk of cancer, stroke, heart attack, cataracts, macular degeneration, erectile dysfunction and osteoporosis,” says Professor Hopkinson.
“The benefits of giving up can have a big impact, even if you do it when you’re older: it’s the difference between being able to walk to the car or not, or being able to play with your grandchildren.”