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If nobody smoked, there would be no chronic obstructive pulmonary disease (COPD), or very little.
Unlike cardiovascular disease where numerous factors are involved, COPD is so closely linked with smoking that if cigarettes did not exist it would be restricted to an epiphenomenon (despite some undeniable work-related cases and those associated with pollution in developing countries).
Preventing COPD by discouraging smoking is therefore a social issue. The most radical weapon is obviously primary prevention, but the potential impact of secondary prevention should not be underestimated.
Patients suffering from COPD who stop smoking while the deterioration of their respiratory function is still limited will not become disabled by the condition. Patients suffering from advanced COPD who stop smoking, are prescribed bronchodilators and receive respiratory rehabilitation will see their quality of life transformed and their need for medical care reduced.
The epidemiological outlook for COPD in view of the expected changes in medical demography suggests that cooperation between general practitioners, hospital doctors and specialists is vital in reaching the treatment levels that will soon be required to restrict the impact of this condition.