COPD & the Non-Smoker

Health Professional
Reviewed by
Thinkstock

You’ve never smoked a cigarette in your life, but your doctor just told you that you have chronic obstructive pulmonary disease or COPD. Are you wondering how this can be? You’re wondering how is this possible? Isn’t COPD a disease associated with smokers and former smokers?

According to a 2011 study published in the journal Chest, about 20% of the population in the U.S. that never smoked will be diagnosed with COPD. Some of the other risk factors for COPD can include:

  • Occupational or environmental hazards. Long-term exposure to certain types of dusts, fibers and chemical fumes can result in the airway inflammation and changes associated with COPD.

  • Second-hand tobacco smoke can be another contributing factor.

  • Air pollution. People who live in areas with poor air quality seem to have a higher risk for COPD. This can be both urban outdoor air pollution (especially in areas with high levels of motor vehicle exhaust) as well as indoor air pollution from wood fires or cooking fire smoke (common in developing countries).

  • Genetics. COPD is more common in relatives of people who have COPD. Experts are not sure why this is. In rare cases, COPD is related to alpha 1-antitrypsin deficiency. This type of deficiency is what usually causes COPD (ordinarily a disease of middle-aged to older adults) in people younger than age 40.

  • GERD. Gastroesophageal reflux disease, GERD for short, causes a backflow of stomach acid and other stomach contents into the esophagus. It can worsen COPD.

  • Other factors. Race, gender (being female), or even chronic lung infections during childhood can contribute to the risk for COPD, though more study is needed to explore these relationships further.

So, while it is not common to find COPD in a non-smoker, it IS possible.

How Is COPD Different in Non-Smokers?

The short answer to this question is, it isn’t different. It may be harder for a doctor to diagnose COPD in a non-smoker, because it is more unexpected. But your symptoms will likely be the same, so diagnosis will come from a medical history, exam and testing such as spirometry.

The course of illness is much the same in smokers and non-smokers. COPD is a chronic progressive airway disease. There is no cure and it will get worse over time, but the disease progression can be slowed with a healthy lifestyle and the right treatment plan. COPD in smokers does often progress more quickly than non-smokers however, because smokers find it hard to quit smoking. The biggest difference in COPD care in non-smokers is the treatment plan. For smokers, the most important part of the treatment plan is smoking cessation (and not to start again). Clearly, for non-smokers, this does not need to be a part of your plan (though avoiding secondhand smoke should be). So your treatment plan will focus on a healthy lifestyle (including sleep, exercise and healthy eating) as well as a medication regime  and possibly pulmonary rehabilitation. There are also newer modalities of treatment options. Avoiding triggers can also help.

Learning to cope with your disease is also an important part of the treatment plan. You might find you have a great deal of anger over getting COPD even though you never smoked. There could be this kind of thinking, “Why the heck was I so good if this is what I get anyway?” It’s important for your ongoing health to learn how to deal with this anger (and your other feelings about your diagnosis) in a positive manner.

Learn more about the physical aspects of COPD as well as tips for coping with the shock of diagnosis in previous articles on this site.

The important thing to remember is that COPD – whether you have been a smoker or never smoked a day in your life – is far from a hopeless diagnosis. You can still live a full and fairly healthy life for some time to come, with the right approach to the disease.