Smoking

Tobacco smoke (including passive exposure) is the most common risk factor associated with COPD. In Europe, cigarette smoking is responsible for 39% of the population’s attributable risk.¹

Smoking cessation is the best way to delay progression of COPD at all stages of the disease. This is as relevant for patients with no current symptoms as it is for those at more severe stages of the disease. Those patients who continue to smoke will see a decline in FEV₁ and lose lung function at a rapid rate, whereas those who stop smoking will deteriorate more slowly (although lost function cannot be regained).

The Fletcher-Peto curve illustrating the effect of continued smoking and smoking cessation on FEV₁ is illustrated in Figure 1.²

Figure 1: Fletcher-Peto curve illustrating the effect of smoking on FEV₁.²
Reproduced from BMJ, [Fletcher C, Peto R. The natural history of COPD. BMJ, 1977:1;1645-1648] with permission from BMJ Publishing Group Ltd.
 

References

1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of COPD. 2011. www.goldcopd.org
2. Fletcher C & Peto R. The natural history of COPD. BMJ, 1977;1:1645-1648.