COPD is the most important chronic

COPD is the most important chronic respiratory illness affecting above all smokers, yet it
remains grossly under-diagnosed. In fact, in just about 13-25% of non-symptomatic
smokers (age > 45 years) COPD was diagnosed after spirometric screening: 80 - 90% of
them showed a mild-moderate disease [12-15]. As a matter of fact, COPD is often
detected when symptomatic and therefore severe. Thus, a diagnosis is usually belated
probably with greater repercussions on healthy costs which are nowadays more and more
difficult to sustain. Therefore, it would be advisable to follow a route of prevention and
early COPD diagnosis in the practical context of primary care, implementing spirometries
and thus encouraging smoking cessation. In fact, primary care clinicians see the vast
majority of patients with early or mild COPD [12-16]. For an early diagnosis in a primary
care setting, a screening strategy, aimed at all smokers, may be more useful than a casefinding
strategy [16]. The recommendation to perform a spirometry on cigarette packaging
may motivate its implementation through an educational awakening both in smokers and
physicians. Also GP's should have a more active role not only by informing smoking
patients about the possibility of developing smoke-correlated diseases but also by
suggesting them to perform tests for an early detection of lung diseases. There are about
1 billion smokers in the world [1]. If one out of 1,000/year performed a spirometry, we
might precociously diagnose COPD for about 130,000-250,000 subjects/year. Such
diagnosis might also induce some of them to quit smoking and therefore, it might notably
reduce morbidity, mortality and costs.