Chronic obstructive pulmonary disease and alcohol: is there a relationship?

Chronic obstructive pulmonary disease is common, treatable, and preventable. Drinking alcohol, even if it does not cause it, can make symptoms worse.

Written and verified by the doctor Mariel mendoza on October 12, 2021.

Last update: October 12, 2021

In chronic obstructive pulmonary disease (COPD), there is a poorly reversible airflow obstruction in the airways, which hinders the exit of air from the lungs. Although chronic alcohol use has not been shown to be a direct cause of chronic obstructive pulmonary disease, this substance Yes, it can influence the worsening of symptoms.

COPD causes shortness of breath, a feeling of shortness of breath, and fatigue from overworking the respiratory muscles. There is also a chronic cough and profuse expectoration.

The diagnosis of chronic obstructive pulmonary disease begins with clinical suspicion and is complemented by spirometry. This studio reflects non-reversible obstruction of the airflow outlet from the lungs.

Causes and treatment for COPD

COPD is classified into two main variants: chronic bronchitis and pulmonary emphysema. The diagnosis of the first is clinical and is defined as the presence of cough and expectoration on most days, for more than 3 months of the year, more than 2 consecutive years.

Pulmonary emphysema, on the other hand, is a pathological diagnosis. It requires the demonstration of permanent enlargement of the alveolar walls, which can be specified with imaging studies.

Spirometry can diagnose COPD.


The typical cause of COPD is long-term exposure to respiratory irritants. The main recognized irritant is tobacco smoke, regardless of the form of consumption (cigarette, pipe, cigars or water pipe).

Exposure to tobacco smoke is the cause of 85% of cases of chronic obstructive pulmonary disease.

Exposure to other types of fumes can also be considered as an etiology:

  • Environmental pollution from biomass fuels.
  • Occupational exposure to dust particles, chemicals, wood and gasoline.

Some conditions are risk factors for chronic bronchitis or emphysema. Among them we have the following:

  • Age: 65 years or older.
  • Respiratory infections recurring.
  • Presence of certain genetic factors: alpha-1 antitrypsin deficiency.
  • Being a smoker current, having been in the past or being a passive smoker.
  • Having asthma


Treatment of COPD involves the use of medications that dilate the airways (bronchodilators). Drugs that decrease inflammation and antibiotics are also prescribed when there is an underlying or concomitant infection.

Pulmonary rehabilitation exercises are recommended for most patients. When the case is severe or has progressed too far, supplemental oxygen may be required.

Alcohol is not the cause of chronic obstructive pulmonary disease

Although alcohol consumption is not a direct cause of chronic obstructive pulmonary disease, they are indirectly related. Prolonged and excessive consumption of the substance tends to affect the immune system and the lungs, increasing the risk of suffering from the disease.

In addition, the association between chronic and excessive alcohol consumption with chronic tobacco consumption is frequent. Many people who smoke also drink alcohol.

Likewise, alcohol can interfere with the effectiveness of the medications used. Especially with antibiotics and steroids.

How does chronic alcohol use affect the lungs and immune system?

Alcohol affects the defense mechanism of the upper airways, modifies the wall of the alveoli, and causes dysfunction of the alveolar macrophages. The latter are the main cell of the immune system in the lungs.

The mucociliary transport system participates in the defense of the upper airways. This is responsible for cleaning the mucus and pollutant particles that enter the respiratory tract, removing them and causing coughing for expulsion.

Alcohol paralyzes the cilia, which prevents the upper airway from clearing pathogens and irritants that enter. Hence, the particles enter the alveolar space.

In the alveolus, irritants or pathogens would have to be eliminated by macrophages. However, in cases of chronic alcohol use and chronic obstructive pulmonary disease, macrophage activity is decreased. In this way, responsiveness and cleanliness fail. Susceptibility to pneumonia is generated.

On the other hand, alcohol reduces the production of surfactant and modifies the permeability of the alveolar walls. This impacts the protection barrier and creates even more susceptibility to infection.

Infections in COPD patients who consume alcohol are more common because their immune system does not respond adequately.

Macrophages and the immune system

The presence of pathogens in the alveolar space activates oxidative pathways that macrophages use to eliminate pathogens. This generates the release of systemic inflammatory factors. that increase oxidative stress and the release of free radicals.

In addition, the pro-inflammatory state affects cell barriers and lowers the levels of the antioxidant glutathione. All combine to increase COPD symptoms in patients who consume alcohol and promote lung injury.

Zero alcohol in chronic obstructive pulmonary disease

The main recommendation for COPD patients is to stop smoking and reduce exposure to secondhand smoke. But do not ignore the effect of alcohol to make recommendations to these people affected with chronic bronchitis or emphysema.

Although chronic alcohol use is not a cause of COPD, influences the exacerbation of the disease. Therefore, chronic smokers, with pulmonary risk factors or who already suffer from the disease, should eliminate alcohol consumption from their intake.

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