Gemma has been living permanently connected to a machine for two years now, without which she couldn't breathe. She is 69 years old and has always been very athletic, passionate about hiking, and has always traveled with her husband in a camper van. Now she can no longer go mushroom picking or swimming in the sea, and she must monitor her altitude when she is in the mountains because of the respiratory failure she suffers from, called chronic obstructive pulmonary disease (COPD)which is closely linked to smoking. She had been smoke-free for ten years when she was diagnosed with this chronic illness, but before quitting, she smoked a pack a day for over 30 years. "I went to the doctor for pneumonia when I was 50, and he told me, 'Either you quit, or you won't make it to Christmas,'" she recalls from her dining room.