Smoking and COPD: what really are the risks?
Smoking is recognised as the most important cause of COPD, with most long-term smokers developing some respiratory impairment. However, through review of the literature and calculation of the ‘population attributable risk’, we identified that only about half of all cases of COPD are due to smoking. This raises the question as to what factors are responsible for the other half, and what can be done to reduce their impact. We proposed that a greater understanding of the causation of COPD is a research priority to provide the basis for the development of primary and secondary prevention programmes. This recommendation does not lessen the significance of tobacco smoking as the most important cause of COPD or the public health importance of measures to reduce tobacco consumption.