The Global Burden of Disease Study, first published in 1997, prioritized the causes of morbidity and mortality from various illnesses and other disorders.  One important finding of the study with which we all are confronted now is the enormity of the burden of non-communicable diseases including that in the developing countries.  The list include the cancers, the cardiovascular and the chronic respiratory disease, most of which are related to tobacco consumption.    Equally importantly, it is observed that chronic obstructive pulmonary disease (COPD) is the only smoking related disease which continues to rise as a cause of death while the others are largely on the plateau of the prevalence curve.  This is a matter of grave concern since COPD which constitutes an enormous health care burden is largely an incurable problem responsible for huge expenditures and other economic losses. What is COPD?  The terminology which looks rather unfamiliar to the lay implies a progressive obstruction to the airflow in the lungs, occasionally referred to as ‘dama’ in common parlance.  Incidentally, the term ‘dama’ is also used for asthma – a reversible allergic disorder common in children and young adults.  On the other hand, COPD is more common in smokers of above 40 years of age, is irreversible and leads to chronic respiratory debility and death in due course of time. The disease is rather common, present in about 5 percent of men and almost 2.5 percent of women of over 35 years of age.  According to rough estimates, this will constitute a burden of about 16 million patients in a population of about one billion.  Almost 80 percent of male patients are chronic smokers.  The important risk factors in non-smoker patients include the presence of chronic exposure to air pollutions, domestic fuel combustion and passive smoking.  A minority of patients may have some genetic or hereditary abnormalities. A COPD patient complains of chronic cough with some sputum production and/or breathlessness with winter exacerbations characterized by purulence of sputum, fever, breathlessness and other symptoms.  The condition slowly deteriorates to develop into chronic respiratory and heart failure over 10-15 year period.  Towards the end, the breathlessness is quite severe rendering a patient as a respiratory cripple for all practical purposes. Quitting tobacco smoking is the most effective treatment in the management of COPD.  It is also the most important step in disease prevention and progression.  Symptomatic treatment of breathlessness is provided with the help of bronchodilators with or without anti-inflammatory drugs administered as inhalers. Pulmonary rehabilitation is another important method to reduce breathlessness and improve the quality of life.  It is important to continue with maintenance treatment and follow the medical advice of the doctor.