Chronic obstructive pulmonary disease: Why is the number of non-smokers with COPD increasing?

An image to illustrate a patient with COPD
© iStock/sudok1

The prevalence of non-smokers with COPD has been increasing. A new study has assessed the associated comorbidities and exposures of non-smoking patients with the disease.

COPD (chronic obstructive pulmonary disease) is defined by the World Health Organization (WHO) as: “Not one single disease but an umbrella term used to describe chronic lung diseases that cause limitations in lung airflow. The more familiar terms ‘chronic bronchitis’ and ’emphysema’ are no longer used, but are now included within the COPD diagnosis. ”

“The most common symptoms of COPD are breathlessness, or a ‘need for air’, excessive sputum production, and a chronic cough. However, COPD is not just simply a “smoker’s cough”, but a under-diagnosed, life threatening lung disease that may progressively lead to death.”

65 million people have moderate to severe chronic obstructive pulmonary disease, according to estimates by WHO.

The study

Researchers examined 180 nonsmoking patients with COPD between the years of 2016 and 2018. Each patient was categorized into either mild, moderate, severe and very severe COPD

The study found that percentage of mild, moderate, severe and very severe patients were 26%, 53%, 58% and 43%, respectively.


The most common comorbidities found among the non-smokers with COPD were:

  • Hypertension (34.4%); and
  • Diabetes mellitus (17.8%).

Environmental factors

Most of the COPD patients (61%) lived in rural areas, while 38% belonged to urban areas. Forty six percent of patients had exposure to biomass gas, while 26% had exposure to toxic gases. According to American College of Chest Physicians, these results support the  theory that biomass fuel exposure is a major contributing factor to COPD, and there is a higher risk among the rural population.

Environmental pollution and household smoke as COPD contributors

The lead researcher Dr. Sameer Arbat said: “Exposure to industrial smoke, environmental pollution and household smoke are major contributors for COPD in nonsmokers. There is a need to study this subset of nonsmokers having COPD further to determine the true cause of this increase.”

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