For many years the main reason why chronic obstructive pulmonary disease (COPD) was linked was smoking, especially among men. But groundbreaking research published recently in BMJ Open Respiratory Research calls into question this long-held belief with a suspicious revelation: women are roughly 50% more likely than men to get COPD, even if they’ve never smoked or smoked significantly less.
This finding calls into question the accepted wisdom, and it calls for a radical change in the way we free-dive through women’s lung health. Researchers analyzed NHIS 2020 data with more than 23,000 US adults (12,638 women and 10,390 men 40+) and the results were shocking. Even though women reported having smoked less frequently, without a daily cigarette carload, having smoked for fewer years, and not having started a smoking habit before the age of 15, women were having a significantly large COPD prevalence.
Figures speak volumes themselves: 8 % of women and 6.5% of men had COPD. Even more striking, among nonsmokers, women experienced double the risk of developing COPD as men did (just over 3% vs. 1.5%). For people who had once smoked, the difference remained, with 16% of women with COPD against 11.5% of the men. After adjusting for several factors male and female gender was associated with a 47% larger risk of COPD, independent of smoking history.
COPD is not actually one single disease but rather a phrase covering chronic lung problems such as emphysema and chronic bronchitis. Gradually these conditions can gradually obstruct airflow so it becomes more difficult to breathe over time. COPD causes lung damage in multiple ways: by reducing the lungs’ elasticity, by inflaming and constricting their airways, by thickening their mucus in the chest, and by damaging the alveoli, those tiny air sacs where oxygen and carbon dioxide are exchanged.
The symptoms tend to often appear gradually—a chronic cough, shortness of breath during minimal exertion, wheezing, or strange sounds from lungs. As the disease advances, a barrel-shaped chest may appear from lung overinflation, or bluish skin may indicate low oxygen levels that are too dangerous. The symptoms of these complaints can seriously impair normal life, making even the simplest activities challenging.
Though smoking continues to be a major cause of COPD, this study emphasizes that we can not attribute the high incidence of COPD among women only to smoking practices. This raises critical questions: Is COPD, caused by non-smoking, more biologically prone in women? Are there not hormonal, environmental, occupational or genetically induced factors concealed? Are women underdiagnosed or undertreated, thus progressing their disease more severely?
The research also discovered another alarming tendency: women with COPD have symptoms expressed more severely relative to men at younger ages. This result provides evidence that the physicians should go beyond the history of smoking to diagnose COPD in women; women’s lung health needs to be considered more proactively.
There are many ways out here to shield women fearful of their lung health. It is advisable to steer clear of secondhand smoke,, as even a little exposure increases the risk. Decreasing exposure to indoor pollution, cooking fumes from wood or irritating chemicals for example, can make that difference too. Those engaged in occupations that are dusty or chemical-intensive should be wearing suitable safety wear. Aerobic exercise helps to maintain lung strength, while a checkup (especially if experiencing unexplained shortness of breath, chronic cough or wheezing) may catch problems earlier.
This study provides an important public health lesson: COPD is neither a smoker’s disease nor a men’s disease. Calls for gender-specific strategies of COPD prevention and treatment, higher research investment in non-smoking causes of COPD among women, and higher public awareness (so women understand their risks and will act early).
Unfortunately, there is not a cure for COPD, but with different drugs it is possible to alleviate the symptoms, slow progression and enhance the standard of living. These are bronchodilators to open up the airway muscles, inhaled steroids to get the swelling down, oxygen therapy for the really bad cases, pulmonary rehabilitation programs, and more lifestyle things such as stopping smoking and avoiding things that irritate the lungs. In severe cases surgery or lung transplantation may be necessary.
Prevention remains the best approach, focusing on reducing exposure to lung-damaging factors. Not smoking—or quitting if you do—is the most important step. Also vital are avoiding secondhand smoke, wearing protective gear if working with chemicals or dust, and reducing exposure to air pollution. Those with genetic risk factors should discuss monitoring their lung health with healthcare providers.
Although BPM follows a progressive course, with adequate early diagnosis, lifestyle modifications, medical intervention and management, many patients are able to live an active life for years or for decades. But this latest research indicates that for women specifically, vigilance is important. COPD’s “usual” risk profile does not reflect the vulnerability of women well, so many women may not be identified unless symptoms reach severe levels.
One thing that is becoming clear, as we get further into understanding this complex disease, is: The attention of women’s lung health deserves to be directed towards evidence-based issues. No matter your profession, policymaking or simply caring about the women in your life, it’s time for you to help raise awareness and advocate for better solutions.
COPD can be silent and progressive but with a greater understanding and a more proactive approach, we can help to ensure it doesn’t remain in the shadows.
