 Do you smoke? Do you have wrinkly skin? Two totally different questions linked by a common factor. It's probable that a quarter of long-term smokers will develop the incurable lung condition chronic obstructive pulmonary disease (COPD). COPD describes a range of conditions, including bronchitis and emphysema, which make it difficult to breathe. Middle-aged smokers with heavily lined faces have a five times higher risk of lung disease, another independent study by Cambridge researchers.
Over 8,000 people living in and around Copenhagen aged 30 to 60 were studied by UK and Danish researchers over 25 years in a study. Ending the study, the researchers found that at least 25% of the smokers without any initial symptoms of the disease had clinically significant COPD, and nearly 40% had some signs of the condition. Over the period of 25 years, 2,900 people died, 109 dying from COPD. Nine out of 10 of those who died were smokers at the start of the research with just two non-smokers dying of the disease.
A spokesman for the British Lung Foundation said the study should act as a "wake-up call" to UK smokers
The chances of COPD was reduced in those people who gave up smoking earlier on in the research and none of the ex-smokers developed severe COPD and only seven died. The lungs of almost all the male non-smokers continued to function well. However, lung function was true for only 60% of those males who continued smoking.
Nine out of every 10 female non-smokers had lungs that functioned well at the end of the 25 year study compared with only seven out of 10 female smokers. This showed quite definitely that most smokers were 'susceptible'.
The researchers who were led by Dr Peter Lange of Hvidovre Hospital, Hvidovre, Denmark, said,
"Our main finding is quite simple - the longer people smoke, the higher the risk of developing COPD."
 Patient with severe COPD He added that there were long-term smokers who did not develop the condition, and more work was needed to find out why there was such a distinction.
"This is an important study showing that people are even more at risk of COPD than we previously thought. It should act as a further wake-up call to smokers to get their lungs tested and to get help to stop. It's also a wake-up call to the United Kingdom - COPD is our fifth biggest killer, yet it's a hidden disease not always shown as cause of death."
More than a million people in the UK are thought to have COPD, but many have not been diagnosed. The World Health Organization estimates COPD will become the third leading cause of death in the world by 2020.
Smoking is already known to cause premature ageing of the skin and is also known to cause most cases of COPD, but not all smokers are affected, leading scientists to speculate there must be a reason why some are more at risk.
Researchers studied 149 current and former smokers, aged 45 to 70, from 78 families around the Cambridge area. Of these 68 people had COPD. Twenty five had severe wrinkling with twenty one having the lung condition.
Taking into account the age and the number of years someone had smoked were taken into account, smokers with lined faces were five times more likely to have COPD.
Facial wrinkling was also associated with triple the risk of more severe emphysema.
Leading the study, Dr Bipen Patel, of the department of respiratory medicine at the Royal Devon and Exeter Hospital, said, "We think there is a genetic susceptibility to acquire COPD. What this research shows is that those who are prone to COPD are also prone to wrinkles. Therefore if there is a gene for COPD susceptibility, it may also increase the chance of someone developing wrinkles." Dr Patel also said that wrinkles could be used as a signal that someone was at increased risk of developing COPD.
Professor Chris Griffiths, British Skin Foundation spokesman from the University of Manchester, said, "It is well documented that smoking is linked to skin wrinkling and this is associated with smoking-induced stimulation of enzymes that break down collagen and the elasticity in the skin. The chronic lung condition emphysema is also associated with loss of elasticity in the lungs and is analogous to wrinkling in the skin. It would be interesting to speculate that the susceptibility to sun induced skin wrinkles and the presence of emphysema are determined by similar mechanisms."
For the British Thoracic Society, Dr Russell said, "Early diagnosis is crucial in COPD. We would encourage smokers, General Practioners and nurses to look out for premature heavy wrinkling in addition to the other symptoms of COPD such as persistent smokers cough and breathlessness."
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