Smoking Archives - Tampa Pulmonary & Sleep Specialists

A clear, science-based guide to breathing better
Michael S. Alvarez, DO, MPH, FCCP

When people think about lung health, they often think about inhalers, oxygen, or medications. While those treatments can be important, research shows that what you do every day matters just as much. How you breathe, how active you are, how you exercise, and how well you prevent infections all play a major role in keeping your lungs working well.

Below are the top five things you can do for your lungs this year, explained in plain language but based on strong medical evidence and international guidelines.

1. Quit Smoking — The Most Powerful Change You Can Make

Quitting smoking is the single most important step for lung health. Smoking damages the airways, reduces oxygen exchange, and speeds up the loss of lung function. Over time, it also increases the risk of infections, flare-ups, heart disease, and cancer.

Experts from the Global Initiative for Chronic Obstructive Lung Disease strongly recommend that anyone who smokes be actively supported in quitting, no matter how mild or severe their symptoms are.

Research shows that nicotine replacement therapies such as patches, gum, or lozenges—along with prescription medications—greatly improve long-term success. People who quit smoking have fewer breathing flare-ups, slower lung damage, better daily breathing, and longer survival, even if they smoked for many years before quitting.

Simply put, no other treatment improves lung health more than stopping smoking.

2. Stay Up to Date on Vaccines to Protect Your Lungs

Lung infections can quickly worsen breathing and cause long-term damage, especially in people with chronic lung diseases. Infections are one of the most common reasons for hospital stays related to lung disease.

Vaccines help protect the lungs by preventing infections or making them much less severe. Based on age and medical conditions, this includes vaccines for influenza, pneumonia, RSV, Tdap, and shingles.

Studies show that vaccinated patients have fewer serious lung infections, fewer complications, and better lung function over time. Vaccines are not just about avoiding illness for a few days—they are a key part of long-term lung protection.

3. Pulmonary Rehabilitation: Exercise That Helps You Breathe Better

Pulmonary rehabilitation is one of the most effective treatments for people with chronic lung disease. It is a structured program that combines exercise training, breathing techniques, and education in a safe and supervised setting.

Most pulmonary rehab programs last about six to eight weeks and include supervised sessions at least twice per week. People who complete these programs often feel less short of breath, can walk farther, feel more confident being active, and spend less time in the hospital. Many also notice improvements in mood and energy.

The exercise portion of pulmonary rehabilitation includes several specific, evidence-based approaches:

Endurance (aerobic) training, such as walking or cycling, is performed at a moderate intensity—usually about 60–80% of a person’s maximum effort. This type of exercise improves stamina and makes daily activities easier.

Interval training uses short bursts of higher-intensity exercise followed by rest. This approach allows people to do the same amount of total exercise with less discomfort and has shown the greatest improvement in walking distance in research studies.

Resistance or strength training focuses on the arms and legs. Stronger muscles reduce the workload on the lungs and have been shown to improve breathing measurements like FEV(1), especially when combined with aerobic exercise.

Pulmonary rehab programs may also include gentle mind-body exercises. Practices such as yoga have been shown to improve breathing comfort and quality of life, particularly in asthma. Tai Chi, Qigong, and Ba Duan Jin—slow, controlled movement practices combined with breathing—have been shown to improve walking distance, lung function, and overall physical ability in people with COPD.

4. Practice Proven Breathing Exercises Every Day

Breathing exercises help the lungs work more efficiently and can reduce shortness of breath. These techniques strengthen breathing muscles, improve airflow, and make activity feel easier.

Pursed-lip breathing is one of the most helpful techniques, especially for COPD. Breathing in through the nose and slowly out through pursed lips helps keep airways open longer and reduces breathlessness.

Diaphragmatic (belly) breathing focuses on using the diaphragm instead of the chest and shoulders. This technique improves lung efficiency, increases breathing muscle strength, and has been shown to improve walking distance.

Yoga-based breathing exercises improve breathing comfort and quality of life, particularly in people with asthma, and can be a helpful addition to daily routines.

Some patients benefit from volume incentive spirometry, which encourages slow, deep breaths to expand the lungs with less strain on the heart and chest muscles. Others may use inspiratory muscle training, which strengthens breathing muscles using gentle resistance. This is most helpful for selected patients with weakened breathing muscles.

These breathing exercises are safe, low-risk, and especially effective when practiced regularly or combined with pulmonary rehabilitation.

5. Stay Physically Active Outside of Rehab Programs

Formal rehab programs are powerful, but daily movement matters just as much. Research shows that people with chronic lung disease who stay active have fewer flare-ups and live longer.

Simple activities like regular walking, stationary cycling, or light strength exercises can make a big difference. Studies show that home-based programs can work just as well as hospital-based rehab when the intensity and frequency are similar. Tools like step counters can help people stay motivated and consistent.

You don’t need special equipment or a gym membership. What matters most is staying active in a safe, steady way that fits into your daily life.

Strong lung health comes from a combination of proven habits: quitting smoking, preventing infections, exercising regularly, practicing breathing techniques, and staying active every day. When these steps are used together, people breathe easier, avoid hospital stays, and enjoy a better quality of life.Many of these strategies work best when they are customized and guided over time.

The Tampa Pulmonary Premium Service is designed for patients who want more time, better access, and personalized support for their lung health. This includes guidance on breathing exercises, exercise plans, pulmonary rehabilitation options, and prevention strategies—all tailored to you.If you’re looking for a more proactive and personal approach to breathing better, we invite you to learn more about our Premium Service.

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References

Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for Prevention, Diagnosis, and Management of COPD – 2026 Report.
Xie J, Guo J, Wang B. Optimal Exercise Modalities and Doses for COPD. Archives of Physical Medicine and Rehabilitation. 2025.
Santino TA et al. Breathing Exercises for Adults With Asthma. Cochrane Database of Systematic Reviews. 2020.
Zhu Y et al. Mind-Body Exercise in Stable COPD. Scientific Reports. 2024.
Burge AT et al. Breathing Techniques to Reduce Symptoms in Respiratory Illness. European Respiratory Review. 2024.
Lu Y et al. Effects of Home-Based Breathing Exercises in COPD. Respiratory Care. 2020.
American Thoracic Society. Update on the Management of Dyspnea. American Journal of Respiratory and Critical Care Medicine. 2012.
Songsorn P et al. Respiratory Muscle Activity During Different Breathing Exercises. PLOS One. 2025.

By: Michael S. Alvarez, DO, MPH, FCCP

Chronic Obstructive Pulmonary Disease (COPD) affects millions of people and remains one of the most common causes of breathing disorders worldwide. For decades, treatment has centered around inhalers, steroids, oxygen, and lifestyle changes. These remain essential, but now there are exciting new therapies that can target the disease in more precise ways.

Some of the biggest breakthroughs are biologic medications like Dupixent and Nucala, which have been used for asthma and are now approved for certain COPD patients. Another new medication, Ohtuvayre, is the first inhaled COPD medication to be approved in more than a decade.

The Foundation of COPD Care

The starting point for COPD treatment is usually maintenance inhalers. Dual therapy inhalers combine two types of medicines, while triple therapy adds an inhaled steroid for more complete control.

When a flare-up—also called an exacerbation—occurs, patients may need a short course of oral steroids such as prednisone, sometimes combined with antibiotics or nebulizer treatments.

But repeated steroid bursts can lead to adverse effects over time, including bone loss, weight gain, diabetes, high blood pressure, and higher infection risk. Even more concerning, the more flare-ups a patient experiences, the faster their lung function declines, which often leads to even more flare-ups. This is the dangerous cycle these new treatments aim to break.

Why Eosinophils Matter in COPD

To understand why biologics work, it helps to know about eosinophils—a type of white blood cell. They normally help fight infections, but in some COPD patients, especially those with chronic bronchitis, high eosinophil levels cause ongoing inflammation in the airways.

Eosinophil counts are measured with a simple blood test. Levels of 150 cells/μL or higher may indicate that a patient could benefit from Nucala. Levels of 300 cells/μL or higher show the strongest evidence for benefit from both Nucala and Dupixent. Patients with high eosinophil counts often have more flare-ups and may respond better to therapies that specifically target these cells.

Dupixent: A Targeted Option for High Eosinophil COPD

Dupixent has been a trusted asthma treatment for years and is now approved for certain COPD patients. It is designed for people with chronic bronchitis-type COPD, eosinophil counts of at least 300 cells/μL, and frequent flare-ups despite being on triple inhaler therapy.

It works by blocking two inflammatory proteins, IL-4 and IL-13, that drive swelling, mucus production, and airway wall thickening. For eligible patients, Dupixent can reduce flare-ups, improve lung function, and make day-to-day breathing easier.

Nucala: Expanding Access to Biologic Therapy

Nucala is another biologic that has been used in asthma for years and is now available for certain COPD patients. It can be prescribed for people with eosinophil counts of 150 cells/μL or higher, with the best results seen at 300 or more.

Nucala targets IL-5, a protein that eosinophils need to survive. By lowering eosinophil numbers, Nucala reduces inflammation in the lungs and decreases the frequency of exacerbations. This makes it an important option for patients whose COPD is driven by eosinophilic inflammation but who may not meet the higher threshold for Dupixent.

Ohtuvayre: A Dual-Action Inhaled Breakthrough

Ohtuvayre represents a major step forward as the first inhaled COPD medication approved in over a decade. It is delivered via nebulizer, allowing the medication to reach the lungs directly.

What makes Ohtuvayre unique is that it works in two ways at once. It relaxes the muscles around the airways so air can flow more freely, and it reduces inflammation to limit swelling and mucus buildup. This is achieved by blocking two enzymes, PDE3 and PDE4, that are involved in both airway tightening and inflammation.

Unlike the biologics, Ohtuvayre can be used regardless of eosinophil levels, making it an option for patients who still have daily shortness of breath despite being on standard inhalers.

Fitting These Treatments Into the COPD Care Plan

COPD care can be thought of as a ladder. The first steps are lifestyle changes—quitting smoking and exercising. Next comes medication with dual or triple inhaler therapy. When flare-ups occur, short courses of steroids and antibiotics may be necessary.
If symptoms or exacerbations persist, advanced options come into play. Dupixent is for patients with high eosinophils and frequent flare-ups. Nucala can be used at lower eosinophil counts but is most effective at higher levels. Ohtuvayre is for persistent breathlessness, no matter what the eosinophil level.

The Promise of Personalized COPD Care

These new therapies mark a shift from “one-size-fits-all” to precision medicine in COPD. By targeting the specific type of inflammation driving the disease, they can reduce flare-ups, protect lung function, and improve overall quality of life.

If you have COPD, our team of doctors at Tampa Pulmonary & Sleep Specialists can help determine whether you might benefit from Dupixent, Nucala, or Ohtuvayre. We can review your history, check your eosinophil levels, and create a plan that fits your needs.

For patients looking for even more personalized care, our Tampa Pulmonary Premium Service offers concierge-style benefits, including direct physician access, same-day or next-day appointments, and extra time to focus on your health.

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Category: Smoking

Top 5 Things You Can Do for Your Lungs in 2026