Lucknow: Chronic obstructive pulmonary disease (COPD) among non-smokers in rural areas of Lucknow is nearly three times the national average, according to a recent study. Experts suggest that urban areas likely have an even higher prevalence due to compounded environmental pollution and occupational risks.
The findings were shared on the eve of ‘World COPD Day’ by researchers from the department of community medicine at King George’s Medical University (KGMU).
The study, titled ‘Prevalence of Chronic Obstructive Pulmonary Disease Among Non-Smokers in Rural Areas of Lucknow,’ revealed an 8.5% prevalence of COPD among non-smoking participants in rural Lucknow, compared to the national average of 3.04% among non-smokers. These rural areas comprise Sarojininagar, Bakshi Ka Talab, Maal and Malhiabad.
Interestingly, the national prevalence of COPD among smokers stands at 8.31%, indicating that the disease burden among non-smoking rural populations in Lucknow is nearly on par with that of smokers nationally.
The researchers involved in the study, Prof Shivendra Kumar and Prof Manish Manar, emphasised the importance of addressing non-smoking-related risk factors.
Prof Manar explained that COPD is a chronic, progressive disease influenced by both genetic and environmental factors. While smoking is a major cause, the high prevalence among non-smokers in rural areas highlights the impact of environmental and occupational exposures.
The study, published in the International Journal of Community Medicine and Public Health earlier this year, surveyed 552 non-smoking participants aged 18 and above in rural Lucknow using clinical histories and portable spirometry.
It found that the COPD prevalence was highest among people with kitchens inside living rooms (10.2%), compared to those with separate kitchens (8.3%) or outdoor kitchens (6.8%).
Similarly, biomass fuel users, such as those using wood or cow dung for cooking (10.3%), had a higher prevalence than those using LPG or electricity (8.2%). Users of incense sticks and mosquito repellents also showed a slightly higher prevalence of COPD (8.9%). However, these associations were not statistically significant, possibly due to limited sample sizes.
Prof Manar emphasised the urgent need for targeted interventions, including community-based screening and preventive strategies, to address the overlooked burden of COPD among non-smokers.
Former director of Vallabhbhai Patel Chest Institute, Prof Rajendra Prasad highlighted the importance of early diagnosis, as symptoms like breathlessness, chronic cough and sputum production are often mistaken for normal ageing or smoking. He emphasised, “To prevent COPD, we must prioritise cleaner air, promote the use of safe cooking fuels like LPG, reduce exposure to environmental pollutants, and ensure early detection through regular screenings.”
Head of the pulmonary critical care department at KGMU, Prof Ved Prakash added that air pollution, especially from pollutants such as PM2.5 and NO₂, exacerbates COPD. Long-term exposure to poor air quality accelerates disease progression and can lead to more hospitalisations due to acute exacerbations.
Prof Prakash also pointed out that indoor air pollution, particularly from biomass fuels, remains a major risk factor for COPD. “By shifting towards healthier lifestyles and creating awareness about the dangers of air pollution and biomass fuel use, we can significantly reduce the burden of this preventable disease,” he said.
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