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Many people suffer a brief attack of acute bronchitis with fever, coughing and spitting when they have a severe cold. Chronic bronchitis, however, is the term applied when this coughing and spitting continue for months and return each year, generally lasting slightly longer each time.
Chronic bronchitis is an inflammation, or irritation, of the airways in the lungs. Airways are the tubes in your lungs that air passes through. They are also called bronchial tubes. When the airways are irritated, thick mucus forms in them. The mucus plugs up the airways and makes it hard for you to get air into your lungs. Symptoms of chronic bronchitis include a cough that produces mucus (sometimes called sputum), trouble breathing and a feeling of tightness in your chest.
In these early phases of chronic bronchitis, the person may lead an entirely normal life, including vigorous sports. Sensitive breathing tests, however, can indicate the beginning of irreversible damage to the lung even at this stage.
The cough becomes more frequent during the daytime and even at night, disturbing sleep. The patient then notices that activities previously tolerated well, cause shortness of breath and perhaps some wheezing. As the disease progresses, shortness of breath may be caused by very ordinary activities such as getting dressed in the morning or having a bath.
Cigarette smoking is the most important cause of chronic bronchitis. Troisi and associates, for example, studied the smoking habits of women enrolled in the Nurses' Health Study, a large prospective cohort study of American women, to assess the relationship between smoking and the occurrence of chronic bronchitis and asthma.
Among 74,072 women, aged 34 to 68 years, 671 cases of newly diagnosed asthma and 798 cases of newly diagnosed chronic bronchitis were identified in 10 years of follow-up. The crude incidence of new-onset chronic bronchitis was highest in current smokers and lowest in never smokers. The relative risk of chronic bronchitis in smokers compared with never smokers increased significantly with increasing number of cigarettes smoked per day, and increased with age. The researchers concluded that rates of chronic bronchitis in smokers are four to five times those in non-smokers.
Approximately 5 years after quitting smoking, chronic bronchitis risk in past smokers approached that in never smokers.
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