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A lifelong smoker is breathless with a barrel chest and pursed-lip breathing. This is emphysema-predominant COPD — smoking destroyed alveolar walls (protease-antiprotease imbalance), lungs hyperinflate (barrel chest, flattened diaphragm), and pursed lips auto-PEEP against collapse. The 'pink puffer' stays oxygenated by effort; the 'blue bloater' (chronic bronchitis) is cyanotic with CO2 retention. Smoking cessation is the only intervention that slows decline — bronchodilators ease, but only quitting changes the slope.