How Our Lungs Work

Lung Function

 Lung Function“Smoking is responsible for almost 90% of lung cancers amongst men, and more than 70% amongst women”

In mechanical terms, our lungs can be described as the site of gas exchange: Oxygen,the fuel all the cells and organs of our body need to function, is extracted there from the air we inhale and infused into the bloodstream, to be distributed to other organs and tissues.

With each exhalation, we dispose of the carbon dioxide that is the by-product of our bodily processes. In our lungs, in the course of a single day, an astonishing 8,000 to 9,000 litres of breathed-in air meet 8,000 to 10,000 litres of blood pumped in by the heart through the pulmonary artery. The lungs relieve the blood of its burden of waste and return a refreshed, oxygen-rich stream of blood to the heart through the pulmonary vein. Below is a shocking picture of healthy lungs and diseased lungs.


Lung Cancer

Smoking is responsible for almost 90% of lung cancers amongst men, and more than 70% amongst women. Worse, when you get lung cancer, you’re very likely to die from lung cancer. It’s 92% fatal among men, and 88% fatal among women.

Smokers are 10 times more likely to die from lung cancer than a non-smoker. If you’ve smoked since a teenager, the lung cancer rate zooms to nineteen times higher. And men who smoke more than a pack a day have about 20 times the lung cancer rate of non-smokers.

Cigarette smokers also run a much higher risk of being struck by many forms of cancer, including cancer of the mouth, larynx, and oesophagus. Cigarette smoking is also associated with higher rates of cancer of the urinary bladder and kidney.


Emphysema is one of several chronic obstructive pulmonary diseases. It causes abnormal swelling and destruction of lung tissue. Lungs maimed by emphysema eventually lose their elasticity. Breathing becomes a continuous agonising struggle.

And there’s little hope for a significant recovery once diagnosed. Lung tissue once destroyed by emphysema can never be replaced, turning its victims into respiratory cripples, who spend agonising years gasping for breath.

Cigarette smoking is also associated with higher rates of peptic ulcers, stomach disorders, and periodontal disease.

If You Could Spend a Day With Me…

Maria Werner-Wasik, M.D. Radiation OncologistHello Max,

As a radiation oncologist, I treat patients with lung cancer every day. One of them is a 31 year old woman now receiving palliative (temporizing) treatment for her widespread small cell lung cancer compressing blood vessels in her chest and making her very short of breath.

She has preschool children at home. She did not smoke very much, but had started young. When I look at her in the waiting room, she appears like a teenager herself. It seems that a lesser amount of smoking is necessary for women than men before they develop lung cancer. A few years ago, lung cancer became the most common cause of cancer death in women in the United States, well ahead of breast cancer. Such is a price women are paying for the Virginia Slims campaign. The cigarettes indeed make those women quite slim. I support your web page and wish you good luck. The idea of showing publicly people dying of lung cancer to deter others from doing so may be repulsive to some, but I support it. People who do not see those patients find it hard to believe that cancer can strike them personally.

If “Saving private Ryan” can show blood pouring from the intestines and film severed extremities on the battlefield to show the truth about war, so can we – anti-smoking activists – show people suffering from cancer, who are willing to share their experience. ”

Maria Werner-Wasik, M.D.
Radiation Oncologist and Assistant Professor, Thomas Jefferson Medical College

Smoking: The Facts

Smoking is a greater cause of death and disability than any other single disease. “Smoking kills almost six times as many people as road and other accidents, suicide, murder, manslaughter, poisoning, overdoses and HIV all put together”

By 2020, the World Health organisation expects the worldwide yearly death toll to reach 10 million, causing 17.7% of all deaths in developed countries. There are believed to be 1.1 billion smokers in the world, 800,000 of them in developing countries.

Break Free

Heart Attack and Stroke

UK studies show that smokers in their 30s and 40s are five times more likely to have a heart attack than non-smokers. Tobacco contributes to the hardening of the arteries, which can then become blocked and starve the heart of blood flow, causing the attack. Often, smokers who develop this will require complex and risky heart bypass surgery. If you smoke for a lifetime, there is a 50% chance that your eventual death will be smoking-related – half of all these deaths will be in middle age. Smoking also increases the risk of having a stroke.

Lung Problems

  • Another primary health risk associated with smoking is lung cancer, which kills more than 20,000 people in the UK every year.
  • US studies have shown that men who smoke increase their chances of dying from the disease by more than 22 times.
  • Women who smoke increase this risk by nearly 12 times.
  • Lung cancer is a difficult cancer to treat – long term survival rates are poor.
  • Smoking also increases the risk of oral, uterine, liver, kidney, bladder, stomach, and cervical cancers, and leukaemia.
  • Another health problem associated with tobacco is emphysema, which, when combined with chronic bronchitis, produces chronic obstructive pulmonary disease.
  • The lung damage which causes emphysema is irreversible, and makes it extremely difficult to breathe.
  • Harm to Children

Smoking in pregnancy greatly increases the risk of miscarriage, is associated with lower birthweight babies, and inhibited child development. Smoking by parents following the birth is linked to sudden infant death syndrome, or cot death, and higher rates of infant respiratory illness, such as bronchitis, colds, and pneumonia. Nicotine, an ingredient of tobacco, is listed as an addictive substance by the US authorities.

Although the health risks of smoking are cumulative, giving up can yield health benefits regardless of the age of the patient, or the length of time they have been smoking.

Future Impact

By 2020, the World Health organisation expects the worldwide death toll to reach 10 million, causing 17.7% of all deaths in developed countries. There are believed to be 1.1 billion smokers in the world, 800,000 of them in developing countries.

The Benefits of Stopping Smoking

After just 20 Minutes:

  • your blood pressure decreases
  • pulse rate drops
  • body temperature of hands and feet increases

In 8 hours:

  • carbon monoxide level in blood drops to normal
  • oxygen level in blood increases to normal

24 hours:

  • chance of a heart attack decreases

48 hours:

  • nerve endings start regrowing
  • ability to smell and taste is enhanced

2 Weeks to 3 Months:

  • circulation improves
  • walking becomes easier
  • lung function increases

1 to 9 Months

  • coughing, sinus congestion, fatigue, shortness of breath decreases

1 Year

  • excess risk of coronary heart disease is decreased to half that of a smoker

5 Years

  • from 5 to 15 years after quitting, stroke risk is reduced to that of people who have never smoked.

10 Years

  • risk of lung cancer drops to as little as one-half that of continuing smokers
  • risk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases
  • risk of ulcer decreases

15 Years

  • risk of coronary heart disease is now similar to that of people who have never smoked
  • risk of death returns to nearly the level of people who have never smoked


I understand smokers, says hypnotherapist Max Kirsten

I understand smokers,” says hypnotherapist Max Kirsten. “I’ve smoked in the cold and rain, I’ve smoked through flu … I’ve had those blind panics when you run out of cigarettes late at night.” A reformed addict turned therapist, Kirsten is credited with helping a host of celebrities quit smoking including actor Ewan McGregor, who had a 40-a-day habit.

London Evening StandardMax Kirsten Evening Standard

McGregor was so impressed that he now endorses Kirsten’s quit smoking iPhone app. The 51-year-old Knightsbridge-based practitioner, who uses hypnotherapy and relaxation techniques to beat cravings, is even the man (it is rumoured) who David Cameron turned to when he decided to conquer his nicotine addiction.


All Kirsten will say is he has treated “a few” politicians “from various parties”. Any he wants to name? “Not really.”

In his twenties and thirties Kirsten had serious recreational drug addiction issues. He grew up in Chelsea, on the King’s Road, where “getting high was the thing to do.” Cannabis, speed, cocaine, heroin – he tried them all. After two stints in rehab, he finally “got off everything” 14 years ago. Except for his 40-a-day cigarette habit, which is when he discovered hypnotherapy.

“People had told me to look into hypnosis. To my amazement, I discovered I became more relaxed in a trance state, and then I just quit smoking. Just like that.”

His positive experience of hypnotherapy inspired him to retrain and help others tackle their addictions and anxieties, from smoking to sleep disorders. Paul McKenna was one of his mentors. Hypnosis has suffered a bad press, I point out. But Kirsten says he doesn’t make patients do anything they don’t want to. Instead, he puts them in a light trance then takes them through a “mental rehearsal” of their daily life – but without cigarettes. Breathing techniques are key to the method. It usually takes only two hours for Kirsten to turn a nicotine addict into a non-smoker. For chronic smokers, though, it can take an extra session.

“Most smokers love smoking. There’s part of giving up that scares them. If you think you can stop, you’re right, and if you think you can’t, you’re right. It’s about a belief system and some people can’t imagine life without a cigarette.”
Kirsten is now happily married with a son of four. Transforming lives is now his “passion”, not drugs.

“It’s a thrilling feeling to think you’ve contributed to the quality of someone’s life. And to be saving [smokers’] lives. It’s an honour.”


  • Get the facts: find out what’s in a cigarette, such as thousands of toxic chemicals. Face up to what your habit really involves.
  • List the benefits: positives include getting back your sense of smell and slowing down the ageing process.
  • Be determined: nicotine takes three days to leave your body but the cravings only last for a few minutes.
  • Face your fears: many people won’t quit for fear they’ll get fat or have cravings. Decide to switch your addiction to something
    positive, like drinking more water.
  • Learn stress management: many addictions are fuelled by an underlying anxiety. Learning to relax is important in quitting.
  • Become a non-smoker, not a former smoker: retrain your way of thinking to quit successfully.