COPD

Overview

COPD is the dominant chronic respiratory disease worldwide. In 2017, 544.9 million people had a chronic respiratory disease, chronic respiratory diseases were the third leading cause of death (7.0% of all deaths), and most of that death and disability burden was due to COPD.^[4] Smoking was the leading risk factor for chronic respiratory disease-related disability in men across all regions.^[4] Almost all of this burden passes through general practice: diagnosis, cessation, inhaler therapy, exacerbation management and end-of-life planning are primary-care work.

The natural history frames every intervention. FEV1 falls gradually over a lifetime, but in susceptible smokers it falls faster; smoking causes irreversible obstructive changes, and stopping smoking does not restore lost lung function — it reverts the rate of further loss to normal.^[3] That is why cessation is the only disease-modifying intervention in COPD, and why it belongs in every consultation with every patient who smokes.

References27ShowHide

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