Video by Dr. Dawn Elise Snipes on integrative behavioral health approaches including counseling techniques and skills for improving mental health and reducing mental illness.

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Smoking, Vaping and COPD
Dr. Dawn-Elise Snipes
OBJECTIVES
~ Learn about COPD
~ Explore the impact of smoking and vaping on COPD
~ Identify the effects of COPD and what social workers, counselors and case managers can do in a multidisciplinary team
What is COPD
~ Chronic obstructive pulmonary disease, or COPD, refers to a group of diseases including emphysema and chronic bronchitis that cause airflow blockage and breathing-related problems and is the third leading cause of death in the US

Causes
~ Long term cigarette smoking or vaping triggering autoimmune response.
~ Several toxins in cigarette smoke have immunomodulatory effects
~ Nicotine increases inflammation
~ Vaping is associated with respiratory illness likely due to vaporized agents introduced into the lungs including heavy metals, acetone, and other carcinogenic compounds.
~ Chronic e-cig vapor exposure downregulated innate immunity against viral pathogens
~ Acute nicotine inhalation through e-cigarette use is associated with increased pulmonary edema and lung injury
~ Exposure to inhaled nicotine-containing e-cigarette fluids triggered reactions associated with the development of COPD including cytokine expression, airway hyper-reactivity and lung tissue destruction

Consequences & Comorbidities of COPD
~ Physical
~ Autoimmune comorbidities
~ Worsening of hyperglycemia in diabetes or steroid-induced diabetes due to common use of steroids
~ Activity limitations (walking/stairs)
~ Fatigue
~ Much higher risk of acquiring and complications from flu, COVID, colds, pneumonia
~ Hypertension related to increased systemic inflammation
~ Lung cancer
~ Sleep apnea
~ Cardiovascular diseases and stroke
~ COPD can damage nerve fibers that connect to the heart and cause arrhythmia
~ Kidney failure which often goes undiagnosed

COPD and Diabetes
~ Nearly twice as many people with COPD have diabetes
~ COPD increases the incidence of diabetes due to
~ physiological changes like inflammation, resistance to insulin and weight gain.
~ Regular use of systemic corticosteroids increases the risk of developing diabetes by 34%
~ Diabetes increases the occurrence of lung infections and worsening COPD symptoms causing an increase in flare-ups
Interventions
~ Physical: Increase motivation and treatment compliance
~ Exercise provides better blood flow and oxygen supply to the brain and releases molecules that could repair the brain
~ Nutrition to ensure a healthy immune system and hormone and neurotransmitter regulation.
~ Some people find that carbohydrate-rich diets worsen symptoms due to the amount of carbon dioxide produced and inflammatory effects of simple sugars
~ Affective
~ Manage depression
~ Manage stress
~ Address grief and anxiety
~ Although COPD is a life-limiting illness, many patients will have other comorbidities that ultimately lead to their death

Summary
~ COPD is mostly preventable.
~ As clinicians it falls under the heading of beneficence to advocate for a smoke-free; nicotine free environment
~ When working with clients, it is important to screen for COPD because it often goes undiagnosed until the person is in later stages of the disease.
~ People with COPD have a variety of biopsychosocial issues they may need assistance learning how to manage.
~ A significant aspect of the behavioral health professional’s work will be to facilitate the grieving process and help prevent secondary comorbidities.

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