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The incidence of chronic obstructive pulmonary disease (COPD), the third leading US cause of death, is reaching epidemic proportions. It is progressive to death and the leading cause is smoking cigarettes.

Differential diagnosis of COPD from asthma is important. Asthma is most likely in patients if they had airway obstruction or a bad chest in childhood.

COPD is characterised by emphysema or chronic bronchitis both of which are due to narrowing of the airways in the lungs. Noxious chemicals usually from tobacco smoke cause an abnormal inflammation in the lungs. Other pollutants such as dust or chemicals in the environment or workplace have also been implicated as possible causes of lung damage associated with COPD.

Smoking is a major risk factor for COPD and cessation is a major preventative approach. Tobacco smoking contributes 80-90% of the risk of developing COPD. The age of starting relates to mortality as…

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