Chronic obstructive pulmonary disease (COPD) is a common and growing problem worldwide.
Although frequently linked with poverty and poor living conditions, there is strong genetic
basis to the disease and chronic exposure to environmental toxins and irritants, such as cigarette
smoking. Inhaled beta-agonists and anti-muscarinic bronchodilators form the basis of both acute
and chronic therapeutic treatment, with inhaled corticosteroids to boost their effectiveness and
reduce the chronic inflammation. Smoking is the most important preventable risk factor for
exacerbation and continued pulmonary deterioration. Patients should be biochemically tested
to verify their self-reported smoking status and given in-house and specialist smoking cessation
advice and counselling. This should be part of the rehabilitation process, which includes exercise
training, education, nutritional intervention, and psychosocial support to improve the efficacy of
pharmaceutical treatment and to enhance physical and mental wellbeing.