Chronic obstructive pulmonary disease, or COPD, refers to a group of lung conditions that block airflow and make breathing difficult. It is possible for people who don't smoke to develop the condition. Symptoms tend to be similar for those who smoke and those who don't.
COPD makes breathing difficult because it restricts airflow in and out of the lungs.
This is because COPD can create more mucus and inflammation, which blocks the airways, causes parts of the lungs to become less elastic, and damages the air sacs in the lungs.
Some symptoms of COPD include:
- frequent coughing that produces a lot of mucus
- tightness or discomfort in the chest
- frequent colds, flu, or respiratory infections
Around 85–90% of people who develop COPD smoke, but people who don't smoke can also develop the condition from exposure to other lung irritants.
In fact, according to the National Institutes of Health (NIH), 1 in 6 people with COPD have never smoked.
One 2015 study compared cases of COPD in 5,176 people, aged 40 or older, who did and did not smoke. People who didn't smoke made up 47% of the cohort, and 10% of those had COPD.
The researchers saw that COPD affected women who did not smoke more than men who did not smoke. Around 70% of those who didn't smoke but had COPD were women.
The common factors that participants who didn't smoke but had COPD shared were:
- being aged 40 or older
- having asthma
- having had a severe respiratory disease as a child
For women, risk factors included being around secondhand smoke and sources of biomass fuel for heating or cooking.
The following may increase the risk of COPD among people who don't smoke:
Genetics play a part in whether a person is at risk of COPD.
A person might inherit a condition called alpha-1 antitrypsin deficiency (alpha-1). This means that people have two abnormal genes inherited from their biological parents.
Approximately 100,000 people in the U.S. have alpha-1, although many people can have this genetic component and not develop a lung condition.
If alpha-1 is causing lung disease, it is called genetic COPD.
People may notice the following symptoms:
- feeling short of breath in everyday activities and exercising
- repeated cases of chest infections or pneumonia
- frequent cough that produces mucus
- bronchiectasis, wherein the airway walls thicken due to inflammation
People can get a blood test to check whether they have alpha-1. Early diagnosis can help prevent the condition from getting worse.
Long-term exposure to pollutants
Indoor and outdoor pollutants can cause COPD in people who don't smoke. Air pollution inside the home is the most common cause of COPD among people who don't smoke.
Pollutants that can lead to COPD include:
- secondhand cigarette smoke
- toxic fumes
- industrial fumes
- exhaust fumes from traffic
Other respiratory conditions
People with chronic asthma may be more at risk of COPD, especially if they find it hard to manage the condition effectively.
People who had severe respiratory infections as children may also have a higher risk of COPD. A family history of obstructive lung disease can also increase the risk.
Those who have had tuberculosis (TB) could also be more at risk, as this disease can cause permanent scarring to the lungs, as well as bronchiectasis and fibrosis (scarring in the lungs).
Research shows that people with a history of TB are three times as likely to develop COPD than those without.
One study looked at 5,176 adults from Canada, all aged 40 and above, to compare the rates of COPD among people who smoked and those who didn't. The cohort comprised 47% people who had never smoked and 53% people who did smoke at that time.
The study revealed that COPD among the people who didn't smoke affected 7.4% of women compared with 5% of men. There were similar amounts of COPD cases in men and women who did smoke.
Also, exposure to biomass fuel affected more women than men. The study defined exposure to biomass fuel as 10 years or more exposure from using a wood, coal, or manure-burning indoor fire as the main source of heating or tool for cooking.
Interestingly, one 2015 study that looked at cases of COPD among people from Korea who didn't smoke found that the condition affected more males than females.
Risk factors for COPD in people who didn't smoke also included:
- having lower rates of education
- working in manual labor
- having a medical history of TB or bronchiectasis
- being older
- being underweight
Some research has found that older age can increase the risk of COPD.
According to the Centers for Disease Control and Prevention (CDC), people ages 65–74+ were more likely to have COPD, according to research from 2013.
People who don't smoke can help lower their risk of COPD by never taking up smoking and trying to stay away from secondhand smoke.
Avoiding pollutants that can irritate the lungs is also one of the best ways to prevent COPD. Staying away from dust, toxic fumes, heavy exhaust fumes, and strong chemicals can all help.
If people work in an environment with frequent exposure to toxic fumes, they should make sure they wear the correct protective clothing and face masks at all times.
If people notice any issues with their breathing, such as a persistent cough or shortness of breath, they should see their doctor for a checkup. Early diagnosis can help reduce the progression of lung disease.
People can also try to protect themselves from getting the flu or chest infections, both of which can increase the risk of COPD. Avoiding large crowds of people during the winter months and getting a yearly flu vaccine can help reduce this risk.
Some research has found that the severity of COPD is lower in people who don't smoke than in those who do.
A 2013 study from Denmark found that people who don't smoke but have COPD had less severe symptoms than those who do smoke. The former group also had a lower risk of complications such as heart problems.
One 2015 study found that people who don't smoke tend to have milder COPD than those who do smoke.
Although there is currently no cure for COPD, there are many treatment options and lifestyle changes a person can try to help manage the condition. If people notice any signs of COPD or shortness of breath, they should see their doctor, as an early diagnosis can help prevent the condition from progressing.
Treatment options tend to include:
- bronchodilators, which help relax the airways to ease breathing
- pulmonary rehabilitation, a program that helps people manage their exercise, nutrition, and overall well-being
- extra oxygen supply
- surgery, if symptoms are severe and medication is not helping
Treatment can help relieve symptoms, help people stay fit and active, and help stop the condition from worsening.