Mr. X was a smoker and knew it was bad for his lungs. But he was more scared about having a heart attack. So he took an ECG every year but it was always normal, and his chest x-rays were clear. Even though he was getting breathless and coughing a lot, he thought it was a normal smoker’s cough. He ignored it till he reached a stage where he couldn’t walk far without breathing difficulty.

Now he has given up smoking, and is on treatment for COPD. It was tough to quit smoking, but with will power he succeeded. He now feels much happier and goes for his morning walk comfortably.

COPD is the short form for Chronic Obstructive Pulmonary Disease. 

  • “Chronic” means that it will not go away. 
  • “Obstructive” means partly blocked. 
  • “Pulmonary” means in the lungs. 

This means that you need long-term treatment for a disease that is causing some blockage in your lungs. 

The air tubes which carry air in and out of the lungs become narrower, so the amount of air that goes in is much less. Also, air cannot get out of the lungs properly. Because of this, the patient feels breathless, his lungs feel very full, and his chest feels tight. These are the symptoms of COPD.


Smoking is the most commoncause of COPD. People who get COPD are usually smokers over 40 years of age. Theymay be ex-smokers who have quit, but already have lung damage. Even non-smokerscan get COPD if they keep breathing in second-hand smoke. Constant exposure tofumes from burning firewood or charcoal is a risk factor. That is how women inrural India get COPD from their cooking stoves {“chula”} or room heaters[“sigri”]. Asthmatics can get COPD if their asthma is not properly controlled.Occupational exposure to dusty or smoky air like coal mines; or otherindustries like cement, textiles and chemicals may also cause COPD.

The patient is asked to doa breathing test called spirometry; by which the doctor grades COPD as mild, moderateor severe; and decides on the treatment plan accordingly. Newer inhaledmedications are safe and effective for long-term treatment. The most importantadvice is to stop smoking and take the prescribed medicines regularly.


The patient’s condition canget worse even if he smokes just two cigarettes a day. Cigarette smoke reducesthe lungs’ immunity against infections. It irritates the airways which getnarrower and produce excess mucus that blocks them. If the patient’s willpowerto quit smoking is not enough, the doctor may recommend a nicotine patch/chewing gum. This nicotine substitute reduces withdrawal symptoms like anxiety,restlessness and craving for tobacco smoke.

To QUIT Smoking:

  • Set a definite date when you will stop smokingcompletely.
  • Tell your friends and family that you are tryingto stop. They will support and motivate you.
  • Take one day at a time. Mark off each successfulday on a calendar.
  • Avoid people who smoke and places that make youwant to smoke.
  • Remove all ashtrays, cigarette packs andlighters from your home.
  • Keep your hands busy. Whenever you feel likepicking up a cigarette, pick up a pencil instead.
  • If you feel an urge to smoke, chew some nicotinegum instead.
  • If you start smoking again, don’t give up onyour goal. On an average, people make 3-4 attempts to quit before they stopsmoking permanently.
  • Keep the air clean in your home. Avoid smoke,fumes, and strong smells. If your house is being painted or pest-controlled,stay away.
  • If you are cooking, keep the kitchen windowsopen and use an exhaust fan.
  • On days when there is lot of pollution and dustoutside, stay at home and keep the windows closed.
  • If you are overweight, it is harder to breathe.Try to lose weight.
  • If you become breathless while eating, eatslowly and talk less.
  • Eat fresh fruits and vegetables; in smallamounts but more frequently.
  • Drink lots of water. This helps make the mucusin your lungs thinner, so that you can cough it out easily.
  • Do breathing exercises. Walk slowly for 20 mindaily. If you feel breathless, stop and rest.
  • If your COPD is very bad and you have beenhospitalised, the doctor may advise you to take oxygen at home. You will have toarrange for an oxygen cylinder or an oxygen concentrator.
  • If breathing becomes very difficult, and it ishard to walk and talk, it may be an emergency. Go to the hospital right away.