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Reasons and Explanations Non-Smokers Might have COPD

Jan 26, 2023 2:25:41 PM / by Ana Eyssimont


Not everyone with COPD is an ex-smoker or smoker,. There are a lot of other factors that cause COPD. While, It is no secret that cigarettes cause a lot of respiratory issues and other bodily harm, and smoking does lead to Chronic Obstructive Pulmonary Disease (COPD) many of the 16 million Americans who have been diagnosed with COPD have never smoked in their lifetime.


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So what else causes COPD and how can we continue to treat this chronic disease for smoker and nonsmokers effectively?

In this blog we cover:

  • What COPD is
  • How COPD and smoking is related
  • How nonsmokers develop COPD



What is COPD?

Chronic obstructive pulmonary disease, commonly referred to as COPD, is a group of progressive lung diseases.


The most common of these diseases are emphysema which slowly destroys air sacs in your lungs, and interferes with outward air flow and chronic bronchitis which causes inflammation and narrows the bronchial tubes allowing excess mucus to build up. Many people with COPD have both of these conditions, and when it is severe enough, they require supplemental oxygen therapy. To treat cases of COPD, people will opt to use portable oxygen concentrators




It’s estimated that about 30 million people in the United States have COPD, while an estimated 14 million are unaware that they have it. If your COPD goes untreated, it can lead to a faster progression of disease, heart problems, and worsening respiratory infections. 

COPD and Smoking 




Smoking is one of the main causes of COPD, however it is not the only reason people develop this disease. 


In today’s day and age, smoking has a negative connotation, and it is widely known that smoking is bad for your health and the ones around you. This scientific fact has only come to light and into popularity in relatively recent years




There was a time when many of us were alive where smoking was a normal everyday thing that most adults participated in, and the negative effects smoking presented to the smoker and those subjected to secondhand smoke were less known and much less talked about.




Now there are a lot more alternatives for smoking for people who want to quit, there are scientific studies proving the harmful aspects smoking has on your body, there are advertisements and movements to help inform people, and smoking is not allowed indoors and even in private outdoor spaces in most areas. 



The overall language surrounding smoking has changed dramatically, and a lot of the time there is little sympathy for smokers. 


While smoking is a very harsh addiction, there are a lot of tools including therapy that can help you quit. It is much easier said than done, and we do have a few resources on our website that can help smokers nick the habit: 




How to Quit Smoking Part 1: Overcoming Doubts & Finding Resources to Help You Quit


How to Quit Smoking Part 2: Coping with Nicotine Withdrawal & Choosing a Quit-Smoking Medication


How to Quit Smoking Part 3: Taking the First Steps and Strategies for Staying Smoke Free 


15 Important Things That Happen When You Quit Smoking


There are a number of other reasons people get COPD later in life, and it's not due to smoking cigarettes. For these people it is important to understand the other reason someone can develop this chronic disease. 

Non-Smokers Who Develop COPD




The most important issue with non-smokers who have COPD is the diagnosis, or lack thereof.


Studies have shown that while COPD symptoms between smokers and non-smokers who have COPD are the same, but in nonsmoking groups the symptoms are less severe. 


Signs of COPD are only present when there has already been significant lung damage caused by the disease. Patients go to their doctors complaining about shortness of breath affecting their normal everyday lives, and then and there, they are tested for COPD


Doctors office-jpg


If someone who has never smoked starts to feel the symptoms associated with COPD they may be less likely to think they have lung damage, and could avoid going to the doctor because they have done nothing in their life that would lead to a pulmonary disease. 


If you have one or several of the following COPD symptoms, seek medical attention immediately:


  1. Shortness of Breath

COPD causes dyspnea, and this is usually the first symptoms people notice, which is why it can sometimes be overlooked. People experience dyspnea in many different ways, it is most commonly described by COPD patients as “feeling like gasping or labored breathing.




When your COPD first starts, shortness of breath might only show up when you exercise or exert yourself more than usual, but as your condition progresses, breathlessness will worsen and you will notice it after activities that weren’t tiring before, such as walking.


When the disease progresses people start to realize they are short of breath from the smallest activities. This is when a lot of COPD patients will seek medical attention.



  1. Chronic Cough

A chronic cough, chronic means it gets worse over time, and medically, it’s defined as a cough that lasts for longer than 8-weeks, is another familiar symptom of COPD. This cough you experience is a result of swelling and inflammation taking place in your airways. Next to dyspnea, coughing is one of the first symptoms you’ll notice, and unfortunately it is often overlooked, especially in smokers because they are summed up to a cough from smoking. 




It is common for smokers to chalk it up to being a “smoker’s cough,” allergies, or their environment.

  1. Coughing Up Phlegm

COPD causes increased mucus production, and you’ll be constantly trying to clear your throat because there is excess mucus in your lungs. You might also develop a cough that brings up mucus, it can be a white, yellow, clear, or even greenish in color.




Your body produces mucus to trap inhaled irritants, and therefore smokers will have more mucus production in their body than the average person.

Other COPD symptoms:

  • Wheezing

  • Chest Tightness

  • Unintentional Weight Loss

  • Headaches


Other Causes of COPD Besides Smoking

So what else causes COPD, if you have never smoked before, and haven’t been around second hand smoke much, what could have caused this disease? 



If you are exposed to long-term air pollution it is very possible to develop COPD. 


COPD can also develop from inhaling dust or the fumes of fuel burned for cooking or heating purposes. 




COPD can also be caused by chemicals or fumes found in harsh workplace environments.



It is true that COPD has a strong genetic component. As many as 5 percent of people with COPD have a genetic condition known as alpha-1 antitrypsin deficiency, a protein that helps protect the lungs from damage. 




People with COPD have too little alpha-1 antitrypsin by causing your lungs to deteriorate, this condition also affects your liver.


If you have asthma this can also play a role in the development of COPD. Research has shown that the presence of asthma helped predict COPD in non-smokers.

Treating Smokers vs. Nonsmokers with COPD 




It is still unknown whether or not COPD in non-smokers has similar or different health related and/or clinical characteristics than COPD in smokers. 


Nonetheless, it is important for you and your healthcare team to treat your COPD based on whether or not you are a smoker, ex-smokers, or non-smokers because you may have different clinical and pathophysiological features due to the years of exposure to different risk factors. 




In theory, the differences between smokers and nonsmokers and their health related issues connected to COPD, are likely to have diagnostic, therapeutic and prognostic significance. 


It is also unknown how we should categorize ex-smoker and non-smoker, either in the same group or as different groups.


While there are no differences in the way we prescribe medicine and treatment management to COPD patients who are non-smokers from the standard care of COPD in smokers.


With that being said, patients in the smokers and smokers groups have different responses to treatment with bronchodilators, corticosteroids, antibiotics and other supportive drugs.


The differences in the number of exacerbations between non-smokers, ex-smokers, and smokers with COPD is still unknown. 


As of now, even though the data within this area is scarce, it is reasonable to believe that non-smokers with COPD do have a distinct clinical phenotype meaning their COPD is distinct from the COPD people have who are smokers. 


Clearly, there is room for investigation and further observation in order to learn more about these unanswered questions.




There are a lot of unanswered questions surrounding the difference between smokers and nonsmokers who both have COPD. It is important to distinguish yourself within one of these groups. 


Smokers do tend to have more severe symptoms and maybe require portable oxygen concentrators, but they are also more prone to chalk these symptoms up to their smoking habit, when in fact it is the emphysema or chronic bronchitis causing them. 




As a nonsmokers it is common to avoid getting diagnosed with COPD because the symptoms of COPD show up more mildly, and therefore you are less likely to seek medical attention. 


Getting tested for COPD is important so you are able to start treating your disease as soon as possible. To learn more about treating COPD effectively, you can navigate to the LPT Medical resource center 

Topics: COPD, wellness goals, COPD education

Ana Eyssimont

Written by Ana Eyssimont