Smoking and COPD: the impact of nature-nurture interactions.

The maintenance of health (homeostasis) and the occurrence of disease such as chronic obstructive pulmonary disease (COPD) are acquired through nature-nurture interactions. The inherited genotype of a person is responsible for producing a deficiency of enzymes called anti-proteases, such as alpha-1 antitrypsin, which protect lung tissue--or for producing an excess of enzymes, such as proteases, which destroy lung tissue. Smoking is discussed in this paper, since it is a major risk factor in the development of COPD, a condition affecting 3 million people in the UK. Research into genetics is beginning to indicate that smoking behaviour may be linked to some form of genetic disposition. Such an association would help health professionals deliver a more patient-centred smoking cessation service. This paper argues that the nurse, in this educator role, can only be considered a partial agent of homeostatic control with patients who have COPD, due to the progressive nature of this disease.