COPD is a progressive, largely irreversible lung disease causing persistent airflow limitation — diagnosed by spirometry (FEV1/FVC <0.70 post-bronchodilator). Symptoms progress from exertional breathlessness to breathlessness at rest, punctuated by acute exacerbations. Tobacco, household air pollution and occupational dusts are the main causes.

What is the difference between COPD and asthma?

COPD is largely irreversible and develops from cumulative damage in older adults. Asthma is a reversible inflammatory condition typically beginning in childhood, triggered by allergens and irritants, and well-controlled with medication in most patients. Both cause breathlessness but through different mechanisms requiring different treatments.

Smoking cessation slows progression at any stage — the most impactful intervention. Bronchodilators (SABAs, LABAs, LAMAs) relieve symptoms. Inhaled corticosteroids reduce exacerbations. Pulmonary rehabilitation improves function and quality of life. Supplemental oxygen for severe hypoxaemia extends life. Influenza and pneumococcal vaccination reduce exacerbation-triggering infections.

Why is COPD underdiagnosed?

An estimated 70% of people with COPD are undiagnosed because symptoms (chronic cough, breathlessness) are normalised as "smoker's cough" and spirometry is unavailable or not performed in most LMIC primary care settings. Case-finding in high-risk populations using handheld spirometers is a growing priority.

How does air pollution cause respiratory disease?

PM2.5 and ozone cause airway inflammation, oxidative stress and progressive lung function decline. Household biomass combustion — affecting approximately 3 billion people — is a major COPD driver in LMICs, particularly in women who cook with solid fuels. Clean cooking fuels and stoves are the primary prevention. WHO's 2021 Air Quality Guidelines set stricter PM2.5 limits than current standards in most countries.

Can COPD be prevented?

Yes — tobacco control prevents approximately 70% of COPD in high-income countries. Reducing household air pollution through clean cooking fuels prevents biomass-related COPD. Occupational exposure controls prevent occupational COPD. Early-life interventions protecting lung development reduce lifetime risk.

What is pulmonary rehabilitation?

Pulmonary rehabilitation combines supervised exercise, breathing techniques, nutritional support and psychosocial care. It is the most effective non-pharmacological intervention for COPD — reducing breathlessness by 20-25% and hospital admissions after acute exacerbations. Despite strong evidence, it is severely underutilised due to limited availability.

What are asthma triggers?

Common asthma triggers: allergens (house dust mite, pet dander, pollen, mould); respiratory infections; exercise; cold air; tobacco smoke; air pollution; aspirin/NSAIDs; and emotional stress. Management combines trigger avoidance with ICS prevention and short-acting bronchodilators for acute relief.

What is the GOLD initiative?

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) produces annual evidence-based COPD guidelines — the international standard. GOLD stages severity by post-bronchodilator FEV1 (GOLD 1-4) and combines with symptom burden and exacerbation history to guide treatment.

The WHO Global Alliance against Chronic Respiratory Diseases (GARD) coordinates national responses to chronic respiratory diseases, particularly in LMICs — through national alliances developing country-specific action plans. GARD brings together professional societies, patient groups, academia and governments.

How do chronic respiratory diseases relate to tobacco?

Tobacco control is the single most impactful respiratory disease intervention: it prevents ~70% of COPD in high-income countries and reduces asthma triggers. Population-level tobacco taxes, advertising bans and cessation support — the WHO MPOWER package — collectively reduce tobacco use and thereby reduce respiratory disease burden.

How does GMJ News cover chronic respiratory diseases?

GMJ News tracks GOLD and GINA guideline updates, air pollution research, tobacco control policy and spirometry access. Chronic respiratory diseases are significant in Georgia given historically high tobacco use, making this a direct public health priority for PHIG and the Georgian Medical Journal.

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Chronic Respiratory Diseases

Q: What is the difference between COPD and asthma?

COPD is largely irreversible and develops from cumulative damage in older adults. Asthma is a reversible inflammatory condition typically beginning in childhood, triggered by allergens and irritants, and well-controlled with medication in most patients. Both cause breathlessness but through different mechanisms requiring different treatments.

Q: How is COPD treated?

Smoking cessation slows progression at any stage — the most impactful intervention. Bronchodilators (SABAs, LABAs, LAMAs) relieve symptoms. Inhaled corticosteroids reduce exacerbations. Pulmonary rehabilitation improves function and quality of life. Supplemental oxygen for severe hypoxaemia extends life. Influenza and pneumococcal vaccination reduce exacerbation-triggering infections.

Q: Why is COPD underdiagnosed?

An estimated 70% of people with COPD are undiagnosed because symptoms (chronic cough, breathlessness) are normalised as "smoker's cough" and spirometry is unavailable or not performed in most LMIC primary care settings. Case-finding in high-risk populations using handheld spirometers is a growing priority.

Q: How does air pollution cause respiratory disease?

PM2.5 and ozone cause airway inflammation, oxidative stress and progressive lung function decline. Household biomass combustion — affecting approximately 3 billion people — is a major COPD driver in LMICs, particularly in women who cook with solid fuels. Clean cooking fuels and stoves are the primary prevention. WHO's 2021 Air Quality Guidelines set stricter PM2.5 limits than current standards in most countries.

Q: Can COPD be prevented?

Yes — tobacco control prevents approximately 70% of COPD in high-income countries. Reducing household air pollution through clean cooking fuels prevents biomass-related COPD. Occupational exposure controls prevent occupational COPD. Early-life interventions protecting lung development reduce lifetime risk.

Q: What is pulmonary rehabilitation?

Pulmonary rehabilitation combines supervised exercise, breathing techniques, nutritional support and psychosocial care. It is the most effective non-pharmacological intervention for COPD — reducing breathlessness by 20-25% and hospital admissions after acute exacerbations. Despite strong evidence, it is severely underutilised due to limited availability.

Q: What are asthma triggers?

Common asthma triggers: allergens (house dust mite, pet dander, pollen, mould); respiratory infections; exercise; cold air; tobacco smoke; air pollution; aspirin/NSAIDs; and emotional stress. Management combines trigger avoidance with ICS prevention and short-acting bronchodilators for acute relief.

Q: What is the GOLD initiative?

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) produces annual evidence-based COPD guidelines — the international standard. GOLD stages severity by post-bronchodilator FEV1 (GOLD 1-4) and combines with symptom burden and exacerbation history to guide treatment.

Q: What is GARD?

The WHO Global Alliance against Chronic Respiratory Diseases (GARD) coordinates national responses to chronic respiratory diseases, particularly in LMICs — through national alliances developing country-specific action plans. GARD brings together professional societies, patient groups, academia and governments.

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Chronic respiratory diseases kill over 3.2 million people a year — led by COPD, the world's third leading cause of death, which affects an estimated 480 million people globally (WHO). Tobacco, household air pollution, occupational dusts and outdoor air pollution collectively drive the epidemic; asthma additionally affects over 262 million, predominantly children. The WHO Global Alliance against Chronic Respiratory Diseases (GARD) coordinates national responses, and the single most impactful policy remains tobacco control — which would eliminate up to 70% of new COPD cases.

Key messages

Scale

Chronic respiratory diseases killed over 3.2 million in 2019 — COPD the third leading cause of death, affecting 480 million; asthma affects 262 million more, predominantly children (WHO/GBD).

Tobacco drives COPD

Tobacco smoking causes approximately 70% of COPD in high-income countries. Household air pollution from biomass cooking fuels drives COPD in LMICs — explaining why women who never smoked develop the disease.

Asthma is reversible

Asthma — largely reversible airflow limitation — is well-controlled with inhaled corticosteroids in most patients. 70% of asthma deaths occur in LMICs where essential inhalers are unavailable or unaffordable.

70% undiagnosed

An estimated 70% of people with COPD are undiagnosed because spirometry — the definitive diagnostic test — is unavailable or unused in primary care settings in most LMICs.

Air pollution link

PM2.5, household biomass combustion and occupational dusts cause COPD independently of tobacco. Climate change worsens air quality and extends pollen seasons, increasing respiratory disease burden.

GARD coordinates response

The WHO Global Alliance against Chronic Respiratory Diseases (GARD) coordinates national responses; the GOLD Initiative publishes annual evidence-based COPD management guidelines.

Key statistics

3.2M

COPD deaths/year

WHO/GBD 2019

480M

people with COPD

WHO/GBD

262M

people with asthma

WHO/GBD

leading cause of death (COPD)

WHO

70%

of COPD caused by tobacco

WHO

70%

of COPD undiagnosed globally

WHO/GOLD

COPD deaths globally per year (millions) 2000-2019 — GBD/WHO

Source: Global Burden of Disease / WHO.

Glossary of key terms

COPD
WHO/GOLDChronic Obstructive Pulmonary Disease — progressive, largely irreversible lung disease with persistent airflow limitation. Diagnosed by spirometry (FEV1/FVC <0.70). Caused by tobacco, air pollution and occupational dusts.

Asthma
WHO/GINAChronic inflammatory airway disease with reversible airflow limitation. Triggered by allergens, exercise, cold air and pollution. Managed with ICS and bronchodilators.

Spirometry
WHO/ERSGold-standard test for obstructive lung disease measuring FEV1 and FVC. Unavailable in most LMIC primary care — the primary reason 70% of COPD is undiagnosed.

GOLD staging
GOLD InitiativeAnnual evidence-based COPD management guidelines — the international standard for diagnosis, staging and treatment.

Inhaled corticosteroid (ICS)
WHO/GINACornerstone of asthma prevention — reduces airway inflammation and exacerbations. ICS/LABA combinations are first-line for moderate-severe asthma.

Pulmonary rehabilitation
ERS/ATSMultidisciplinary programme (exercise, education, psychosocial support) reducing breathlessness, improving exercise capacity and reducing hospital admissions in COPD.