COPD Not Related to Tobacco
Chronic obstructive pulmonary disease (COPD) is one of the most important public health problem causing high
morbidity and mortality worldwide. Although cigarette smoking is the main established risk factor in COPD, the
current epidemiological studies revealed that the burden of COPD in never smokers is much higher in contrast to
previously believed. The interaction between genetic predisposition and exposure to environmental factors other
than smoking such as exposures to occupational agents, biomass smoke may lead to the development of COPD.
Respiratory infections in childhood, pulmonary tuberculosis, chronic asthma, indoor and outdoor air pollution,
poor socioeconomic status may also be important in never smoking COPD population. To date, very few data
is available about non-smoking phenotype of COPD or comparing with the smoking phenotype. Our current
knowledge on the management of COPD is mainly based on former or current smoking COPD patients. So it is
not known whether the available data could be implemented to nonsmoking subjects precisely or not. Therefore,
increased awareness and understanding of the novel risk factors in nonsmoking COPD population and future
studies addressing the answers of the questions regarding the management of this specific population are needed.
Key Words: COPD, Tobacco smoke, occupational exposure, biomass, risk factors, epidemiology, COPD in never