A large and growing number of COPD patients in Kolkata have never touched a cigarette, say city doctors, raising concern over the rapid rise in cases of Chronic Obstructive Pulmonary Disease among non-smokers.
On World COPD Day, we take a closer look at the trend that has doctors worried.
Why non-smokers are developing COPD
Dr Sujan Bardhan, consultant pulmonologist at Narayana RN Tagore Hospital, explains that non-tobacco smoke exposure and rising pollution levels have driven up cases of COPD among younger people in recent years.
“Non-tobacco smoke exposure and worsening pollution are pushing COPD cases up even among young individuals and non-smokers,” he says. He adds that poor nutritional intake and the continued use of biomass fuel among rural women have also contributed to the surge.
“Low nutrition and long-term exposure to biomass fuel—especially among rural women—are major contributors,” Bardhan notes.
Dr Raja Dhar, director and head of Pulmonology at CK Birla Hospitals, CMRI Kolkata, calls the trend alarming. “COPD among non-smokers is now a bigger problem in India than smoking-related COPD,” he says.
He points out that large sections of the developing world still rely on biomass fuel for cooking and this exposure results in COPD among non-smokers.
The condition is also no longer confined to the elderly. Dhar recalls treating a 26-year-old man from Malda whose severe breathlessness began at 19. The cause was traced back to several years of childhood exposure to biomass smoke in a poorly ventilated kitchen. “This single case shows how environmental factors can cause severe and early-onset COPD in non-smokers.”
The environmental crisis behind the disease
Indoor air pollution remains the biggest culprit. Homes that depend on wood, dung or crop residue for cooking generate high levels of particulate matter that can cause irreversible lung damage. Outdoor pollution adds another layer of danger. With 15 of the 20 most polluted cities in the world located in India and air quality levels far below WHO norms, doctors warn that prolonged exposure significantly raises COPD risk.
There are other triggers that often go unnoticed. Dhar warns that even continuous exposure to incense stick smoke or smoke from religious rituals can harm the lungs. “Even something as routine as incense smoke, when inhaled regularly, can injure the lungs,” he cautions.
Living near industrial zones or thermal power plants also increases vulnerability. In rare cases, a genetic condition called Alpha 1 Antitrypsin Deficiency leads to early onset of COPD and may require a lung transplant before the age of 40.
How to protect yourself and prevent COPD
Doctors say prevention begins with reducing exposure. Bardhan advises people to stop smoking, maintain adequate daily intake of calories and protein, exercise regularly and avoid noxious fumes. “Avoid smoking, eat well, stay active and keep away from toxic fumes,” he says.
Dhar stresses the importance of avoiding outdoor activity when the air quality is poor. “When the air quality is poor, staying indoors is one of the most effective safeguards.”
Vaccination plays an important role in preventing flare ups. Dhar recommends an annual influenza vaccine before winter and the conjugate twenty pneumonia vaccine that offers protection for nearly a decade. Early recognition of worsening cough, sputum, wheezing or breathlessness is essential to avoid complications and hospitalisations.