“And she began to cry. But something was wrong. The woman was fumbling frantically in her large handbag. “I can’t cry!” she croaked, her voice faint.

I suddenly realized how quiet it was. Her shoulders and chest were heaving, but she wasn’t breathing. She was trembling, the tears streaming down her cheeks, and she couldn’t take a breath to use the inhaler. I sat still, trying to look calm, my mind racing. After an interminable moment she sucked in a couple of wheezy puffs. “If I cry,” she said, still panting, her face pale, “I can’t breathe. I can’t allow myself to cry.”

Then it struck me. Regular breathing was hard enough with her emphysema; crying — with its deep irregular inhalations — crippled her ability to draw in air.”

25% of American adults smoke (50 million people), 15-20% of smokers have airflow obstruction (COPD).

70% of smoker have made at least one attempt to quit, 46% make an annual attempt.