Abstract
Introduction
Smoking is the primary risk factor for chronic obstructive pulmonary disease (COPD); however, non-smoker COPD is increasingly recognized. Approximately 70% of COPD cases are linked to smoking, while 25%–30% occur in non-smokers, often due to factors such as biomass fuel exposure, air pollution, occupational hazards and respiratory infections. In Asia, indoor/outdoor air pollution and poor socioeconomic status significantly contribute to non-smoker COPD. This study aimed to identify variables and comorbidities associated with acute COPD exacerbation (AECOPD) in smokers and non-smokers.
Methods
This prospective hospital-based study (January 2018–June 2019) included 70 patients with AECOPD, diagnosed as per GOLD 2017 Guidelines, at a tertiary care hospital. Ethical approval and informed consent were obtained. Patients were classified as smokers (n = 36) and non-smokers (n = 34).
Results
Of the 70 patients (61.4% male), breathlessness was a universal symptom. Severe COPD exacerbation was more frequent in non-smokers, and comorbidities were higher, though not statistically significant. Smokers had higher mMRC dyspnea and CCQ scores, indicating greater symptom burden, despite similar pulmonary function.
Conclusion
Smokers exhibit higher symptom severity, while non-smokers experience more severe exacerbations and comorbidities. Non-smoking risk factors, such as biomass fuel exposure and poor socioeconomic conditions, are critical in COPD pathogenesis. Comprehensive evaluations and personalized treatments are vital, with future research needed on COPD phenotypes and biomarkers.