November is COPD Awareness Month, an opportunity to learn about chronic obstructive pulmonary disease (COPD), recognize its warning signs, and understand how early diagnosis and treatment can help people breathe easier and maintain their quality of life.
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that makes it difficult to move air in and out of the lungs. It is a major cause of illness and death in the United States. According to the Centers for Disease Control and Prevention (CDC), 4.4% of U.S. adults reported having been diagnosed with COPD, emphysema, or chronic bronchitis in 2025. Nearly 16-million American adults have been diagnosed with COPD, and many more may have the disease without knowing it. In 2024, COPD mortality among adults age 45 and older was 89.1 deaths per 100,000 people, after adjusting for age. Chronic lower respiratory diseases, a broader category that includes COPD and asthma, ranked as the fifth-leading cause of death in the United States in 2024, accounting for 145,643 deaths. Annual medical costs associated with COPD among adults age 45 and older have been estimated at $24 billion.
COPD often develops gradually over many years. Early symptoms may be mild or go unnoticed, and some people do not recognize a problem until breathing becomes more difficult.
Common symptoms include:
- Shortness of breath, especially during everyday activities
- A persistent cough, sometimes producing mucus or phlegm
- Wheezing or chest tightness
- Difficulty taking a deep breath
- Fatigue or reduced ability to remain physically active
- Frequent respiratory infections
Shortness of breath and a persistent cough should not be dismissed as normal signs of aging. If you notice these symptoms, particularly if they persist or worsen, contact your healthcare provider. Early diagnosis can help you begin treatment sooner and may help slow the progression of the disease.
COPD is commonly associated with two conditions: chronic bronchitis and emphysema. A person may have features of both.
Chronic bronchitis involves ongoing inflammation and irritation of the bronchial tubes, the airways that carry air to and from the lungs. This inflammation can cause increased mucus production, a persistent cough, wheezing, and shortness of breath.
Chronic bronchitis is traditionally defined by a cough that produces mucus for at least three months per year in two consecutive years, after other causes of the symptoms have been considered. It can make breathing more difficult and increase the risk of respiratory infections.
Chronic bronchitis is one of the conditions associated with COPD, although not everyone who has chronic bronchitis has COPD. Diagnosis requires an appropriate medical evaluation.
Emphysema damages the tiny air sacs, called alveoli, where oxygen passes into the bloodstream and carbon dioxide is removed. The walls between these air sacs can break down, reducing the surface area available for gas exchange. The lungs may also lose some of their normal elasticity, making it harder to breathe air out.
The damage caused by emphysema cannot be fully reversed. However, treatment can help relieve symptoms, improve daily functioning, and slow further damage.
Smoking is the leading cause of COPD, but people who have never smoked can develop the disease, too.
Other risk factors include:
- Exposure to secondhand smoke
- Long-term exposure to workplace dust, chemical fumes, and other lung irritants
- Indoor or outdoor air pollution
- Certain respiratory infections and other factors affecting lung development
- Genetic conditions, including alpha-1 antitrypsin (AAT) deficiency
AAT deficiency is an inherited condition that can leave the lungs more vulnerable to damage. People with COPD should discuss whether testing for AAT deficiency is appropriate with their healthcare provider.
There is currently no cure for COPD, and damage to the lungs cannot generally be reversed. However, treatment and lifestyle changes can help control symptoms, reduce flare-ups, and improve quality of life.
Stop smoking. If you smoke, quitting is one of the most important steps you can take to slow the progression of COPD. A healthcare provider can recommend counseling, medications, and other resources to help you quit.
Stay physically active. Regular physical activity, adapted to your abilities and health, can help maintain strength and endurance. Talk with your healthcare provider about safe activities and how to increase your activity level without overexerting yourself.
Ask about pulmonary rehabilitation. Pulmonary rehabilitation is a supervised program that combines exercise training, education, breathing techniques, and support for people living with chronic lung disease. Research shows that pulmonary rehabilitation can improve exercise capacity, reduce symptoms, and enhance quality of life for many people with COPD.
Follow your treatment plan. If you do not understand the instructions on your treatment plan, reach out to your healthcare provider.
Stay current on recommended vaccinations. Respiratory infections can cause serious complications for people with COPD. Ask your healthcare provider which vaccines are recommended for you.
Know when to seek help. Contact your healthcare provider if your breathing, cough, or mucus production changes or your symptoms worsen. Severe difficulty breathing, blue or gray lips or fingernails, or new confusion require emergency medical attention.
If you or someone you care about has a persistent cough or unexplained shortness of breath, do not assume it is simply part of getting older. Talk with a healthcare provider about whether a lung-function test, called spirometry, is appropriate. Recognizing COPD early and getting appropriate care can make a meaningful difference in everyday life.