A constant cough isn't just an expected side effect of smoking. It could be the first sign of a serious lung condition called chronic obstructive pulmonary disease (COPD). COPD is the third-leading cause of death in the United States and a significant cause of disability.

Most people are more familiar with the terms emphysema or chronic bronchitis, but COPD is the term doctors are using more today. "COPD is a term that the scientific and medical community is trying to get the public to recognize. It encompasses both chronic bronchitis and emphysema. The reason we combined them is because they come from the same thing, mostly smoking, and they usually coexist," explains Norman Edelman, MD, senior medical advisor for the American Lung Association in Washington, D.C.

COPD is a progressive condition, which means that it gets worse as time goes by if nothing is done to slow the course of the disease. Doctors can't cure COPD or undo lung damage, but treatment can improve your symptoms and limit complications. Changing your lifestyle by giving up smoking, staying physically active, eating a balanced diet, and taking any medications prescribed by your doctor can help you remain active and healthy longer.

What Happens in Your Lungs With COPD

COPD is characterized by changes in your airways and the air sacs in your lungs. These changes, which all reduce your ability to breathe easily, include:

  • Less elasticity of the lungs, meaning that your airways can't expand as well as they used to when you breathe.
  • Destruction of tissue walls between the air sacs (or alveoli), which means there is less ability to take in oxygen from air.
  • Swelling of your airways due to irritation of the lining.
  • Production of a greater amount of mucus, which then makes it harder to breathe.

The Timeline of COPD


"We think anybody who is at risk for COPD — that is anybody who has ever smoked — and anybody who is short of breath for any reason, even if they haven't smoked, should talk to their doctor and request a test we call spirometry. It's a simple test that measures how well you breathe," says Edelman. Depending on the results of that test, you might need further testing to find out if you have COPD or another lung disorder.

Initially you may only have COPD symptoms such as coughing or shortness of breath when you’re physically active. Periods when symptoms become worse are called COPD flares, or exacerbations. As the disease progresses, shortness of breath may occur even at rest and flares may occur more frequently.

Although it is a chronic condition, there are many ways to live well with COPD and keep the condition from progressing. Gaining a better understanding of COPD can help you make choices that will prolong your health and improve your quality of life.