“A former First Lady of the United States of America and relentless proponent of family literacy, Barbara Pierce Bush passed away Tuesday, April 17, 2018 at the age of 92," read a statement from the office of George H.W. Bush. “She is survived by her husband of 73 years, President George H. W. Bush; five children and their spouses, 17 grandchildren, seven great grandchildren; and her brother Scott Pierce. She was preceded in death by her second child, Pauline 'Robin' Bush, and her siblings Martha Rafferty and James R. Pierce.”
While the announcement did not confirm the cause of death, CNN reported this week that Bush struggled with Chronic Obstructive Pulmonary Disease (COPD) and congestive heart failure. The 92-year-old had also battled Graves' disease, a thyroid condition, in the past.
COPD is a chronic inflammatory lung disease that causes obstructed airflow from the lungs, according to the Mayo Clinic. Sufferers experience symptoms like shortness of breath, wheezing, chronic coughing, and frequent respiratory infections. The disease stems from long-term exposure to irritating gases or air particles, most often from cigarette smoke. About 20 to 30% of smokers develop COPD.
The strong ties between the habit and the disease have prompted many people to wonder if the first lady smoked, a habit she admitted to in her 2015 autobiography, Barbara Bush: A Memoir
"The year 1968 began with me taking a very important step: I gave up smoking," she wrote. "I had been a smoker since age 18 and knew I should quit but just never did."
She went on to recall a time when she had gone to the hospital for a small surgery, and had woken up in the middle of the night and lit a cigarette while still groggy from medication.
"At that very moment a tiny nurse came into the room, got me back into bed, and before charging out of the room, informed me she'd be back to talk to me in the morning," Bush remembered. "True to her word, after she got off duty, she took the time to come in and read me the riot act. She told me I was addicted and a disgrace. Addicted? Me? I couldn't forget that nurse and on New Year's Day I quit."
While Bush beat her nicotine addiction decades ago, she apparently smoked very heavily for the 25-year period between 1943 and 1968. The mom once "smoked Newports by the pack," according to a 1992 Vanity Fair profile.
While the Bush family hasn't confirmed whether Barbara is one of the 15.7 million Americans with COPD, they revealed she spent her final days in "great spirits." "She’s a fighter. She's an enforcer," the TODAY anchor and granddaughter Jenna Bush Hager said on Monday.
Hager added that her grandpa - Barbara's husband of over 73 years - remained close by her side. "I think the fact that they’re together and that he still says, ‘I love you Barbie’ every night is pretty remarkable,'” she stated.
Barbara personally addressed her health problems in a 2013 interview with CSPAN. "I don't have a fear of death for my precious George or for myself because I know that there is a great God," she said at the time. "I know we'll see Robin again, one way or another, and our families. I have a great faith."
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