"COPD? At my age? I'm only 46! There's no way. I'm too young to have that horrible disease."

Dave was stunned. Lately he'd been a little more short of breath than usual, and his colds hung on for longer than they used to, but this... this just couldn't be.

"COPD is a disease for old people," he thought. "Old smokers who are hunched over, crabby, wrinkled, and have an oxygen hose in their nose. That's not me...or is it?"

So, what's Dave to do? There are three paths he can take:

• Go home, sit in his chair, give up and let COPD get the best of him.
• Pretend like he had never been diagnosed with COPD and try to go ahead as if he had the lungs of a 20-year-old tri-athlete.
• Accept that he has COPD, learn all he can, and do all he can to be healthy as possible and to live a long life.

What do you think he'll do? What would you do? Here are some commonly asked questions about being young with COPD.

How common is COPD andat what age?

According to the American Lung Association:

• More than 12 million people in the United States have COPD. Another 12 million have COPD but go undiagnosed.
• COPD is the fourth leading cause of death in the U.S. and the only one in the top ten on the rise.
• It is estimated that 80-90% of COPD cases are due to smoking.

According to the British Thoracic Society:

• About one in eight people who smoke one pack of cigarettes a day develop COPD, and one in four people who smoke two packs a day develop the disease.

But here is something that may surprise you: In 2000, 3.9% of those living in the U.S. between the ages 25 and 44 had COPD. Nearly 8% were between the ages of 55-64 and 9.5% were over 74 years old.

How young is young?

COPD can be diagnosed in adults as early as their 20's and 30's, but COPD diagnosis in people in their 40's is on the rise, says Dr. Neil Schachter, medical director of respiratory care at Mount Sinai Medical Center in New York City. Better methods of diagnosis and an increase in awareness by doctors as well as patients are the main reasons.

What are the primary causes of COPD in younger people?

1.) One cause is Alpha-1Antitrypsin Deficiency, a genetically inherited form of COPD in which a person is born with two recessive genes, one from the mother and one from the father. In this disorder there is a lack of a protein in the blood called Alpha-1 Antitrypsin. The main function of this protein is to protect the lungs from inflammation caused by infection and inhaled irritants such as tobacco smoke. To check if you might have Alpha-1, take this quiz.

2.) Early onset of COPD that is not related to Alpha-1 is caused by a combination of:

• Heredity - getting it passed down from your parents
• Exposure to environmental breathing irritants such as dust, chemicals, and pollution
• Cigarette smoking
• Repeated lung infections as a child
• Second hand smoke exposure as a child

What if you develop COPD when you're young and you're not correctly diagnosed?