Smoking-related chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a growing problem worldwide and a major cause of disability, hospital admission and premature death (Pauwels and Rabe, 2004). It is projected to become the third most common cause of death by the year 2020 (Murray and Lopez, 1996). From the patient’s perspective, it is also a disease that has a profound effect on quality of life (Rennard et al, 2002). COPD is an umbrella term used to describe a number of lung conditions that obstruct airflow and make breathing difficult. COPD is multifactorial (stemming from a number of different causes or influences) and multigenic (genes may also play a significant role in why some people who smoke develop COPD). It is a progressive disease process which becomes more severe with time although signs and symptoms vary greatly between individuals. It is characterised by an abnormal inflammatory response which leads to irreversible structural and functional changes within the lungs and airways resulting in chronically poor airflow. Key point: Chronic bronchitis and emphysema are common types of COPD. Asthma, which results in chronic airway obstruction, is traditionally recognised as a distinct disease from COPD although there are shared overlapping features.