The most common cause is...

The most common cause of emphysema is smoking, whether it be cigarettes, pipe smoke or even drugs like marijuana or crack. Smoke temporarily paralyzes the cilia that line your bronchial tubes, which normally clean germs and irritants out of your airways. With smoking, those irritants remain in your bronchial tubes, inflaming the alveoli and breaking down the elastic fibers.


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Other causes:

A small percentage of sufferers get emphysema due to a protein deficiency, specifically a protein called alpha-1-antitrypsin (AAt), which protects the lung structures from the destructive effects of certain enzymes. If you’re a smoker with an AAt deficiency, onset of emphysema can begin in your 30s.

Other risk factors include age, exposure to secondhand smoke, exposure to chemical fumes, pollution, dust and other lung irritants. HIV infection can also put one at greater risk, especially if the infected is also a smoker.