Have you ever wondered why some people develop breathing problems even if they don’t smoke, while others seem unaffected despite years of smoking? The answer lies in a mix of genetics and lifestyle habits. Chronic Obstructive Pulmonary Disease (COPD) is one such condition influenced by both, but in India, it’s mostly our daily habits and environmental exposures that are to blame.

According to the Global Burden of Disease (GBD) 2016 study, more than 90% of the disease burden (DALYs) in India is caused by environmental and lifestyle factors like smoking, air pollution, and occupational hazards. Genetic causes, on the other hand, account for only a small percentage of COPD cases.

Dr. Bhavana, Consultant in Pulmonology at STAR Hospitals, explains how understanding your personal risks, both genetic and lifestyle-related, can help prevent or slow the progression of this chronic lung disease.

What Causes COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a long-term condition that affects airflow in and out of the lungs. It includes diseases such as emphysema (damage to the air sacs) and chronic bronchitis (inflammation and mucus buildup in the airways).

COPD develops slowly over time, often due to exposure to irritants like smoke, dust, or chemical fumes that damage the lungs. While smoking is the most common cause, not all smokers develop COPD, this is where genetics and environmental triggers come into play.

Genetic Factors

Although rare, genes can play a small role in the development of COPD.

• Alpha-1 Antitrypsin Deficiency (AATD): This is the primary genetic cause of COPD, found in about 1% of all cases. It occurs when the body doesn’t produce enough of the alpha-1 antitrypsin (AAT) protein, which protects the lungs from inflammation. People with this condition may develop COPD even if they have never smoked.

• Family History: If you have a close relative with COPD, your genetic predisposition may be higher. Combined with lifestyle risks like smoking or pollution exposure, your chances of developing COPD increase further.

Knowing your genetic risk can be helpful. Today, simple genetic tests can detect AAT deficiency and other lung-related gene variants, allowing you to take preventive measures early.

Daily Habits and Environmental Factors

In most cases, COPD results from long-term exposure to lung irritants.

• Smoking: The number one risk factor. Cigarette smoke damages the lung tissue and narrows the airways over time.

• Second-hand Smoke: Even if you don’t smoke, inhaling others’ smoke regularly can cause lung inflammation and damage.

• Air Pollution: In India, both outdoor pollution and indoor smoke from cooking fuels play a major role in COPD development.

• Occupational Exposure: Workers exposed to dust, coal, or chemical fumes over many years are at higher risk.

• Chronic Lung Infections or Asthma: Repeated lung infections or poorly managed asthma can weaken the lungs and make COPD more likely.

• Age: COPD usually affects people over 40 because of cumulative exposure to irritants that gradually damage the lungs.

Understanding Your Risk

If you have a family history of COPD, it’s important to avoid smoking and minimize exposure to air pollutants. Those with alpha-1 antitrypsin deficiency may notice symptoms at a younger age and must stay completely away from smoking. Sharing your diagnosis with family members can help them check their own risks through medical screening.

Simple lifestyle changes like quitting smoking, wearing protective masks at work, improving indoor ventilation, and scheduling regular lung checkups can greatly reduce your risk and slow disease progression.