A 60-year-old man gets admitted to the intensive care unit of a tertiary care hospital with complaints of fever and breathlessness for two days. He is diagnosed as a case of COPD (chronic obstructive pulmonary disease) with respiratory failure, just hours before he knocks at the doors of death. Though he had troublesome respiratory symptoms for many years, and has been moving around consulting more than half-a-dozen doctors, none has made a precise diagnosis of COPD. Had the diagnosis been made earlier, it would have been possible to prolong his life, if not saving him permanently from the icy hands of death.

This is just one example. The bitter truth is that a large number of COPD cases (of course, a few other respiratory diseases too) go undiagnosed, misdiagnosed or under-diagnosed and get undertreated/mistreated in our country or rather throughout the globe, leading to permanent complications and poor quality of life thereafter. A simple test called spirometry would make a precise diagnosis of COPD.

According to the World Health Organisation's global estimates, 210 million people have COPD. The rate of morbidity and mortality from COPD will increase over the next 20 years and make COPD the third leading cause of death (currently the fourth) and the fifth leading cause of disability.

I do not underestimate the potential of the Indian medical fraternity, but the slackness with which it deals with respiratory care needs to be modified. This slackness has been utilised, rather misused, by the self-advertising and recently the legally insulated quacks (in the medical field) and the crude and brutal treatment administered by them has added to the burden of respiratory handicaps.

So what is this COPD? A condition where your airway loses its elasticity and becomes rigid, i.e., your airways which are like rubber tubes turn into plastic tubes.

As a result, there is airflow limitation in and out of the lungs, thereby compromising oxygen supply to the whole body. As a result, the person becomes breathless, coughs up, expectorates troubling himself and his loved ones for years before he dies a painful death.

Tobacco smoking is the main culprit behind the cruel damage. However, smoke from other sources has also been implicated but to a lesser extent. An exponential increase in cigarette smoking in the Indian subcontinent has alarmingly increased the prevalence of COPD.

With global warming, the risk of premature death among chronic respiratory patients is up to six times higher than in the rest of the population.

Hence, much has to be done to chase out this social evil. A mere pictorial warning on tobacco products will not help. Healthier lifestyles should be inculcated and reinforced as the kid grows.

Beware: if you kiss a cigarette, it reciprocates by biting your lungs. So those who smoke quit it today, and those who do not never ever think of starting it. Remember, “Lighting up a cigarette would darken your life permanently.” The theme for world COPD day ‘2010-The Year of the Lung: Measure your lung health-Ask your doctor about a simple breathing test called spirometry.'

(The writer is post-graduate student in Thoracic Medicine, Thanjavur Medical College, Thanjavur, Tamil Nadu. His email id is: drpdorai@yahoo.com)

Keywords: smoking