Chronic obstructive pulmonary disease (COPD) encompasses two groups of lung disease, chronic bronchitis and emphysema. Chronic bronchitis refers to a productive cough for at least 3 months of each of 2 successive years for which other causes have been ruled out. Emphysema describes destruction of the lung architecture with enlargement of the airspaces and loss of alveolar surface area.
COPD prevalence increases with age, but there is a dramatic synergy with smoking such that smokers have higher COPD prevalence and mortality and lung function losses as a function of amount smoked are dose-dependent. Unlike heart disease, quitting smoking does not produce substantial reversal of tobacco – harmful effects once COPD is established. As a result, in much of the developed world, COPD is increasing as a cause of death as cardiovascular death rates fall.
As with other tobacco-associated adverse health effects, smoking either cigarettes or cigars increases risks of COPD. Thus, cigar smokers are reported to have a 45% higher risk of COPD when compared to nonsmokers.
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