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ABSTRACTChronic obstructive pulmonary disease (COPD) is a global and rising problem worldwide. While in most ways linked to poverty and deprivation, there is also a strong genetic component to the disease and long-term exposure to environmental irritants and toxins such as cigarette smoking. Inhaled beta-agonists and anti-muscarinic bronchodilators form the foundation of both acute and chronic therapeutic management, with inhaled corticosteroids to augment their effect and reduce the chronic inflammation. Smoking is the most important modifiable risk factor for exacerbation and chronic pulmonary deterioration. All patients should be biochemically screened to verify their self-reported smoking status and encouraged to accept in-house and specialist advice and counselling to stop smoking. This should be incorporated as part of the rehabilitation program consisting of exercise training, education, dietetic advice, and psychosocial intervention in an attempt to maximize the efficacy of drug therapy and preserve physical and mental health.Key Words: Beta-agonist bronchodilators, antimuscarinic inhalers, corticosteroids, oxygen therapy, smoking rehabilitationDEFINITIONChronic obstructive pulmonary disease (COPD) is a long-term, progressive lung disease that makes breathing difficult to breathe and get enough oxygen into the body and carbon dioxide out of the body because of chronic changes in their airways and lungs. A progressive disease affecting your lungs and the ability to breathe.INTRODUCTIN COPD is a long-term disease that doesn't go away and usually gets worse over time. COPD is the 4th cause of death. Estimates of Chronic Obstructive Pulmonary Disease (COPD) patients in India are from 37.8 million to 55.3 million. The figures of COPD cases are bound to rise due to the increasing burden of the disease in women and low- and middle-income countries (LMICs).Women are 37% more likely to develop COPD than men and 2X more likely to develop bronchitis. There were an estimated 480 million chronic obstructive pulmonary disease (COPD) cases globally in 2020. COPD is a long-term disease that doesn't go away and usually gets worse over time. COPD is not curable, but symptoms can improve .COPD is one of the most preventable diseases. The most important cause of COPD is long-term use of lung damaging irritants, such as: Cigarette smoke (the most important cause of COPD) Long-term cigarette smoking is one big risk for COPD alone. The more years and packs, and at a younger age, and less and less, and when and how often, your larger your chance will become. Pipe and marijuana and cigar smoking can contribute to your chance, too. Breathing in second-handsharing smoke High concentrations of inhaled second-hand smoke can have a chance at getting COPD, too. Toxins in your environment Long-term work-related exposure to fumes, smoke, vapours and dusts can puff and inflame your lungs, and make your chance for COPD larger. Genetics can become a part, too, in a genetic disease, an alpha-1 antitrypsin deficiency, that can cause COPD in non-smokers. In approximately 1% of persons with COPD, it is a result of a gene mutation in family clusters, an emphysema in a genetic form. This gene lessens the level of a protective protein, a-alpha 1-antitrypsin (AAT), in your lungs and blood. Deficient AAT can cause disease in your lungs and your liver, with symptoms at an early age in family clusters with a family history of COPD. Repeated early life infection. Other genetic factors can make cigarette-smoking persons have a chance for developing COPD.

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