I've long belabored the point in this blog and elsewhere that the primary description for COPD causes is misguided. That smoking, "the smoking gun" if you will excuse the pun, is NOT the primary cause of COPD, never mind what CDC and AMA and ALA have promoted and proclaimed for sixty plus years.
My first clues date back to my first term on the Colorado Air Pollution Control Commission, when we were assured by CDC that Colorado was the 2nd worst state per capita for Emphysema (the primary portion of the COPD cluster), and neighboring Utah was 15th. Married to a Mormon girl, I thought, "They don't allow smoking in Utah, how can that be?"
Armed with a dizzying pile of Z-fold computer printer paper with a decade of Colorado Health Dept statistics from their fancy new IBM 370-195 in 1970, I transferred the data to an unknown personal computer several years before the world knew of such a thing (the HP 9100A), and created a novel geographical demographic sheet for every death. It revealed that smoking (and not incidentally the bad urban air of every Colorado city) did not correlate with the deaths. Instead, small (often sub-micron) particulate matter, in a trapped toxic air environment, correlated extremely well.
This is all outlined in some detail in an essay entitled "Confronting COPD". https://www.researchgate.net/publication/236865558_Confronting_COPD
For years, I'd show the CDC maps (seen sporadically throughout this blog for years) that indicated poor correlation with smoking for COPD deaths but great correlation for Lung Cancer deaths.
Now, a disturbing truth is emerging on a world scale. Even Lung Cancer now seems less related to smoking, and more to small-particulate toxic air, as Taiwan continues to experience surging Lung Cancer deaths in non-smokers. Oh, my, how can CDC explain this one?
From the Journal of Clinical Oncology, reported at the 2024 annual meeting, "Lung cancer incidence in Taiwan has been rising with the epidemiological profiles distinct from Western country. Notably, nonsmoking lung cancers accounts for more than 60% and half of lung cancers were diagnosed in advanced stages."
https://ascopubs.org/doi/10.1200/JCO.2024.42.16_suppl.8009
Indeed, this story has been brewing for some time. Two years ago this week, Climate News published a story over the headline, "Lung Cancer in Nonsmokers? Study Identifies Air Pollution as a Trigger." Author Victoria St. Martin sub-titled it, "Researchers have discovered how tiny particles from fossil fuel emissions exploit a gene mutation to promote the growth of cancer."
This study 'fingers' coal-fired power-plant emissions, much as my study a decade ago does. And it notes that we're now finding that 20% of American lung cancer victims were never smokers. By the wya, America's energy needs have resulted in 600% increase in power plant emissions since my CAPCC study--could there possibly be a relationship? Duh...
And COPD is more susceptible to this phenomenon than Lung Cancer. Whew. When with geospatial demographic studies begin to make an impression?
