COPD, smoking, and social justice

It is 60 years since the UK Royal College of Physicians published its ground-breaking report Smoking and Health,1 and chronic obstructive pulmonary disease (COPD) and its underlying pathologies, chronic bronchitis and emphysema, are now well established as potential consequences of smoking. The inhalation of noxious materials contained in tobacco smoke drives lung inflammation, oxidative stress, premature ageing, and immune function impairment. These processes lead to damage to the airway epithelium and vascular endothelium, as well as destruction of small airways and alveoli.