COPD, smoking behaviour, and the importance of teachers as role-models for adolescents

Chronic obstructive pulmonary disease (COPD) has been described by the ATS (American Thoracic Society)/ERS (European Respiratory Society) guidelines [1] as a disease "characterized by airflow limitation that is not fully reversible". The diagnosis of COPD should be considered in any patient who experiences cough, sputum production, or dyspnea in association with specific risk factors, which for the vast majority is cigarette smoking [2,3]. COPD has long been acknowledged as a major cause of respiratory disability, but the magnitude of its impact has been only recently recognized. According to the World Health Organization, COPD will reach the 3rd rank as cause of mortality [4] and 7th rank as cause of disability by 2030 worldwide [5]. COPD represents a huge burden for the healthcare systems and causes increasing costs to society due to absence from work, visits to the doctor's clinic, medication, and hospital admissions.