Combatting COPD: ‘Smoking remains main reason for prevalence of disease’

Prevention best way to counter Chronic Obstructive Pulmonary Disease, say experts.

KARACHI: “It’s hard to put into words how 40 years of smoking has made me suffer. All I can offer is advice to not smoke,” said a 70-year-old former sportsman, while sharing his story of how his quality of life spiralled down because of the habit.

He was speaking at an awareness session held to observe Chronic Obstructive Pulmonary Disease (COPD) at the Aga Khan University on Thursday. The elderly man burst into tears while recalling his days as a sportsman, saying he continued to suffer due to shortness of breath.



Another participant raised the point that although he doesn’t smoke, he has shortness of breath and can’t run. “It is an age factor,” replied Prof Javaid Khan of the Pulmonary and Critical Care Medicine at AKU.

According to health experts, prevention remains the best way to counter the growing menace of COPD. Enforcement of anti-smoking laws in public space, pollution control and better ventilation in homes were listed as key preventive measures.

“Smoking remains the prime reason for COPD. About seven million Pakistanis are suffering from this disease, out of which 90 per cent are smokers. About five per cent of the total population of Karachi [above the age of 40] suffers from COPD,” disclosed Prof Khan. “The calculated COPD prevalence of 2.1 per cent in Pakistan in people aged 40 and above is likely to be a gross underestimation as exposure to biomass fuel and water pipe (shisha) smoke were not accounted for.”

In his opinion, the increasing use of cigarettes and shisha in the country would lead to higher rates of COPD in the future. Of the more than 60 million annual deaths that occur worldwide from the illness, almost 90 per cent occur in low and middle-income countries like Pakistan.

Despite the increasing prevalence of the disease, a number of options are available for the treatment of COPD. “Several medications, oral as well as inhaled, have been found to be useful in the treatment of COPD over the recent few years, while new medications are also in the process of being developed or tested,” said Dr Ali Zubairi, section head of Pulmonary and Critical Care Medicine. “Pulmonary rehabilitation, a comprehensive programme that combines education, exercise training and nutrition counselling, also leads to significant improvement in the quality of life of patients.”

Patients, especially smokers, with symptoms should seek early medical consultation so that they can be diagnosed and given the write treatment. It is important for patients to understand that even in advanced COPD, medications can help improve the quality of life.

“Famous poet Jaun Elia was diagnosed with advanced COPD,” said Prof Khan, quoting his words, “’I thought my poetry was because of smoking but I was wrong. It snatched my quality of life.”’

He said that there are only three benefits of smoking; the smoker never gets old because he dies too early, a thief can’t enter his home because he coughs throughout the night and dogs can’t bite smokers as they carry a stick too early.

Published in The Express Tribune, November 23^rd, 2013.