Future generations spared the ‘ticking time bomb’ of COPD if plans to curb smoking are given the green light

Despite being the third biggest cause of death worldwide, most people have no idea what chronic obstructive pulmonary disease is and couldn’t recognise basic tell-tale symptoms, a leading lung charity warns on World COPD Day

Asthma + Lung UK is urging people to see their GP if they experience ‘classic symptoms’ of breathlessness, a persistent cough, wheezing and mucus

Despite being the third biggest cause of death worldwide, most people have no idea what chronic obstructive pulmonary disease (COPD) is – and couldn’t recognise basic tell-tale symptoms, a leading lung charity warns on World COPD Day (Wednesday 15 November).1

COPD is an umbrella term for a group of incurable lung conditions, including chronic bronchitis and emphysema that make it difficult to breathe air out from the lungs.2 More than 1.4 million people in England, aged forty or over have the condition.3

Symptoms include getting out of breath completing everyday tasks like going for a walk or doing housework, having a cough that lasts a long time, wheezing and bringing up more mucus than usual. COPD is a progressive disease with no cure, and even with treatment, a severe flare-up can be fatal. The sooner someone gets a diagnosis, the more likely they are to live a longer, fuller life.4

While some people with the condition have no history of smoking, exposure to cigarette smoke is by far the biggest cause in the UK, with recent data revealing that nine out of ten people with COPD either smoke or have a history of smoking.5 This means that the Government’s proposed plan to create a smokefree generation by raising the legal age for buying cigarettes by a year every year would effectively protect millions of younger people from developing the disease and could make COPD a relatively rare disease in the future.

But the proposed clampdown on smoking, which would also include doubling funding to smoking cessation support services to £138 million a year, isn’t a done deal yet and will have to go through a parliamentary vote early next year.6 That is why Asthma + Lung UK is urgently urging the public to back the proposals by writing to their MPs and asking them to support the legislation when parliament votes on the proposed plans.

Last year, COPD cost the NHS £38 billion in England alone and the disease was responsible for 26,878 deaths in the UK – to put this in context, for every five lung cancer deaths, there are four from COPD.7,8,9 Yet awareness of this debilitating condition remains worryingly low, with at least 500,000 people now living undiagnosed with the illness.

In a further survey from Asthma + Lung UK, 44 per cent of respondents admitted they hadn’t even heard of COPD until they received a diagnosis, and 80 per cent claimed their symptoms had got worse over the past year.5

The charity is warning people not to dismiss frequent breathlessness as a normal part of getting older, and to see their GP if they have any symptoms of COPD. The warning comes amid growing concerns that those living with undiagnosed and untreated lung conditions are at increased risk of becoming seriously ill if cases of respiratory infections like Covid and flu spiral this winter.

For those with a diagnosis of COPD, who still smoke, the best thing they can do is to stop. They should also discuss a personalised treatment COPD plan with their doctor, and make sure that they get an annual flu jab and a regular pneumococcal and Covid vaccine and are given access to pulmonary rehabilitation (an exercise and breathing programme that helps people with COPD) if they are eligible.10

Steve Bowen, a 68-year-old former police officer from Essex, was diagnosed with COPD in October 2020 after smoking for more than fifty years. Steve said: “I had my first cigarette at nine and was soon hooked. After countless attempts to quit, I finally gave up smoking in January 2020 as my chest was constantly rattling and wheezy, I had an endless cough, constant phlegm and I couldn’t sleep for more than an hour at a time.

“One morning, nine months later, I was on my way to collect my grandson from pre-school when I started to feel scarily breathless and began to panic. Luckily someone I knew came to my rescue, and called an ambulance, but during the two-hour wait, I was convinced I was going to die. At hospital, I was told I had suspected COPD, and I later received an official diagnosis. I was also told that during my time as a smoker, I’d lost two-thirds of my lung function.

“Determined to take control of my COPD, I gradually made myself walk for seven miles three or four times a week. Since then, I’ve started running half marathons and have lost two and a half stone. The biggest challenge for me has been trying to educate myself about COPD as nobody seems to know what it is. Pulmonary rehabilitation was a gamechanger, but I had to really fight for it. I’m just glad my grandchildren won’t be able to buy tobacco if this legislation gets through and will be spared a lifelong addiction and this horrible disease.”

Professor Nick Hopkinson, Medical Director at Asthma + Lung UK and a practising respiratory consultant, said: “The proposed increase in the age of sale for tobacco products is fantastic news for lung health as cigarette smoke is the major cause of COPD and this clampdown could protect people from developing the illness, although childhood deprivation and exposure to occupational dust fumes and chemicals are risk factors too.

“COPD can be a ticking timebomb as people tend to ignore the key symptoms which are pretty straightforward: a persistent cough, mucus, wheeze, and breathlessness. A simple lung function test where people breathe into a device called a spirometer is used to diagnose COPD. Unfortunately, there’s this belief that frequent breathlessness is a normal part of getting older which it is not, and people quietly withdraw from life until they experience their first real exacerbation and can no longer ignore their symptoms.

“Putting off going to the doctor can result in gradual lung damage and increases someone’s risk of having a life-threatening flare-up. COPD is a neglected lung condition – and unfortunately, lung conditions are pretty neglected in general. This is something we urgently need to change.”

Sarah Woolnough, CEO of Asthma + Lung UK, said: “For far too long people with COPD have been left behind, with so many living half-lives, unaware that they even have this illness. That is why it’s so important to make people more aware of the symptoms so they can get the right treatment as quickly as possible. The best way of preventing COPD is to avoid or give up smoking which is why we need to get the proposed smokefree legislation through parliament. It’s our chance to safeguard the health of the next generation, and to diminish the prevalence of preventable lung disease.

“Smoking kills 76,000 people in the UK every year and has a devastating impact on the quality of people’s lives. Four out of five smokers take up the addiction before the age of twenty, and so preventing smoking in young people is vital if we want to protect them from a lifetime of addiction and poor health.11,12

“This is a once in a lifetime opportunity for policymakers to make a stand for lung health and to make smoking history. We know that many politicians are still unsure of how they will vote which is why we are asking people with a lung condition to make their voice heard by writing to their MPs and telling them why curbing the sale of cigarettes is so crucial.”

Asthma + Lung UK is calling on people to contact their MP to urge them to support the smokefree legislation by clicking on the link to Tell your MP to make smoking history. For more information and support on COPD, visit www.asthmaandlung.org.uk or call 0300 222 5800.

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References:

1. World Health Organization Chronic obstructive pulmonary disease (COPD) (who.int)

2. NHS https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-cop…

3. Taskforce for Lung Health https://pubmed.ncbi.nlm.nih.gov/37497381/

4. Impact of COPD diagnosis timing on clinical and economic outcomes: the ARCTIC observational cohort study COPD_A_195382 995..1008 nih.gov

5. Data via analysis of Asthma + Lung UK’s Life with a Lung Condition survey, which ran from January – March 2023. The survey ran online and received 14, 460 responses from people with lung conditions, including 4,821 people with COPD

6. DHSC October 2023 Stopping the start: our new plan to create a smokefree generation: www.gov.uk

7. Asthma + Lung UK's Saving Your Breath reporthttps://www.asthmaandlung.org.uk/saving-your-breath

8. Data via Office for National Statistics (ONS; England and Wales), National Records of Scotland, Northern Ireland Research and Statistics Agency (NISRA)

9. Nomis official census and labour market statistics https://www.nomisweb.co.uk/query/construct/summary.asp?mode=construct&v…

10. NICE recommendations of COPD care NICE guidelines

11. NHS https://www.nhs.uk/common-health-questions/lifestyle/what-are-the-healt…

12. Public Health England - Health matters: smoking and quitting in England www.gov.uk