Dr. Anika Parrikar
Associate Consultant – Interventional Pulmonology and Lung Transplant, Aster Whitefield.
When people hear the term COPD Chronic Obstructive Pulmonary Disease the first thing that usually comes to mind is cigarette smoking. And while smoking is indeed a major cause, the story in India is far more complex. Here, COPD has many faces, many triggers, and affects millions who have never touched a cigarette in their lives. In fact, India has one of the highest burdens of COPD globally, fuelled not just by tobacco but also by household smoke, pollution, occupational exposure, and longstanding infections.
Why is COPD so common in India?
Unlike many Western countries where COPD is almost synonymous with smoking, the Indian scenario is unusual. Yes, tobacco smoking and passive smoke are big contributors, but they are only part of the problem. In rural and semi-urban parts of the country, cooking on chulhas using firewood, cow dung, or charcoal generates massive amounts of smoke. Women, who spend years in poorly ventilated kitchens, inhale these fumes every day putting them at equal risk of developing COPD as a smoker.
Urban environments present a different challenge. Rising air pollution, construction dust, traffic fumes, and particulate matter all damage the lungs slowly but steadily. Even younger individuals now report early breathlessness, chronic cough, and wheezing because of continuous exposure to polluted air.
How does COPD develop?
COPD is a chronic, progressive disease that affects the airways and lung tissues. Over time, irritants like smoke or pollutants cause inflammation inside the lungs. This leads to narrowing of the airways and destruction of air sacs, resulting in symptoms such as:
● Persistent cough and mucus
● Breathlessness on exertion
● Wheezing
● Frequent respiratory infections
● Fatigue or reduced stamina
While smoking weakens the lungs by direct chemical exposure, chulha smoke and pollution have a similar effect by releasing fine particles that reach deep into the respiratory system. Long-term exposure becomes especially dangerous because the lung damage continues silently for years before symptoms become noticeable.
Why isn’t COPD recognised early?
For decades, breathlessness has been normalised especially among women and older adults. Many assume it’s simply “age,” “weakness,” or “low stamina.” In busy cities, people blame pollution-induced cough on seasonal changes and move on. There is also limited awareness that non-smokers can get COPD, which delays diagnosis and worsens outcomes.
Another challenge is the stigma attached to chronic cough or breathing difficulty. Many hesitate to seek help, fearing they might be labelled as smokers or unhealthy.
What can be done to prevent or delay COPD?
While environmental factors are difficult to eliminate completely, several steps can help protect lung health:
● Reduce exposure to smoke: Use cleaner cooking fuels like LPG, improve ventilation, or opt for smokeless chulhas.
● Avoid smoking: Quit smoking and avoid passive smoke wherever possible.
● Protect yourself from pollution: Use masks in high-pollution areas and avoid strenuous outdoor activity on bad-air days.
● Strengthen your lungs: Regular walking, breathing exercises, and yoga can help improve lung capacity.
● Early screening: People with chronic cough, breathlessness, or long-term exposure to smoke should get lung function tests like spirometry.
● Timely treatment: Inhalers, medications, and lifestyle changes can control symptoms and prevent complications if started early.
Why awareness matters
COPD is not just a smoker’s disease — it’s a major public health issue shaped by how India cooks, lives, travels, and works. Recognising the multiple faces of COPD can help people seek help sooner and take preventive steps. When we understand that lung health is deeply influenced by our everyday environment, we can make informed choices, protect vulnerable groups, and work toward cleaner, healthier living spaces.
COPD may be chronic, but it is manageable — especially when detected early. With awareness, early action, and cleaner habits, we can reduce the burden of this silent, growing disease and help millions breathe easier.
About the Author
