English singer Amy Winehouse is no stranger to tabloid headlines -- routinely grabbing attention for alleged drug use, brushes with the law, bizarre onstage behavior and curious fashion choices.

Yet a recent disclosure that the 24-year-old has ''signs of emphysema,'' according to her U.S. publicist, Tracey Miller, shocked many. Though copious photos show the beehived songstress with a cigarette dangling from her lips, it seemed stunning to learn that someone that age could suffer from a disease usually associated with two-pack-a-day 65-year-olds.

But Winehouse is not an anomaly. Health experts say that young adult smokers are no strangers to mild emphysema, a shortness of breath caused by damage to the lung's small air sacs. Smoking can permanently deteriorate the lungs, irreversibly diminishing lung capacity -- and the damage starts young, even in teens who smoke five cigarettes a day, according to one 1996 study from the Harvard School of Public Health and the Brigham and Women's Hospital in Boston of 10,000 youths who smoked.

`PERMANENT DAMAGE'

''Teenagers and people in their 20s think they're invincible,'' said Dr. Norman H. Edelman, chief medical officer for the American Lung Association. ``They think they can wait until they're 35 to stop smoking and everything's going to be fine, but they can do permanent damage before that.''

The damage can come in the form of emphysema, which is caused by some of the 4,000 to 5,000 toxic chemicals in cigarette smoke. (None in particular is known to be the source of the damage, but collectively they create chaos in the lungs.) Activated oxygen molecules in the smoke trigger inflammation that can't be controlled, said Dr. Jonathan Samet, chairman of the epidemiology department at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

Even in early stages of emphysema (defined generally, Samet said, as having less than 80 percent lung function), the chemicals are breaking down the lung's tiny air sacs, called alveoli. The consequence: ''A grape-like cluster of tiny air sacs becomes one big sac, which means there is less area to exchange oxygen,'' Edelman said.

Inflammation, Samet said, reduces the air sacs' elasticity, making it harder for them to expand and contract, moving air in and out. ``It's like the difference between a balloon filled with air and a paper bag filled with air.''

As well as emphysema, Samet adds, smoking can cause chronic bronchitis, the lung inflammation characterized by irritation and scarring. ``There are a lot of extraordinarily irritating substances in tobacco smoke. The lung has defense mechanisms that can clean out things that get in. But smokers dump so much toxic stuff in that the lungs can't keep up.''

MORE TROUBLE

Adding illegal drugs to the mix -- such as marijuana or crack cocaine -- can exacerbate the problem, although experts aren't sure if either directly causes emphysema. ''It basically compounds the issue,'' said Dr. Zab Mosenifar, medical director of the Women's Guild Lung Institute at Cedars-Sinai Medical Center in Los Angeles.

Edelman said some of the bronchitis inflammation is reversible, but the lung damage of emphysema is not -- and continuing to smoke results in less and less lung function over the years. (Everyone's lung function declines with age, but that of smokers declines faster.)

Young adults with mild emphysema might notice slight physiological changes -- a pickup basketball game becomes more arduous, or lugging groceries produces a little wheezing. A singer such as Winehouse may not be able to hold long notes with ease.

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