COPD is as a result of a wide variety of environmental,
behavioural, and genetic conditions. Approximately
85‑90% of all cases of COPD arise from cigarette
smoking, with the remaining 10‑15% arising from
passive smoking, occupational exposure, air
pollution, genetic disturbances, progressive and
possibly hyper responsive airways (Tzortzaki et al
2005; Downs and Appel 2007). It is considered
to be a chronic and not fully reversible disease;
thus, treatment is aimed at providing symptom
control, supportive care and assistance in disease
self‑management. The goal of treatment is not to
cure the disease, rather, it is to palliate symptoms,
maintain physical functioning, and prevent further
disability, as well as to decrease unplanned hospital
visits and, thus improve health related quality of life
(Bourbeau et al 2003; Monninkhof et al 2004; Linnell
2005; Chen et al 2008).