Can we PLEASE stop COPD shaming?

When asthma and COPD come up in the same conversation, I’ve often heard “I didn’t cause my disease” spill out the mouth of someone with asthma. To put it bluntly, I’m sick of seeing this seeming superiority complex emanate from people who could instead choose to be empathetic, not spiteful.

Who gets COPD?

The facts. Just like asthma, COPD has a degree of genetic disposition. Only 20-25% of people who smoke go on to develop COPD—some sources cite this number closer to 10-16%^{1, 2}—in either case, this  is hardly a majority of smokers, which indicates something is different between those smokers who do develop COPD and those who do not, namely genetics. Just because a person has COPD also does not mean that they smoked—COPD can also develop caused by occupational irritants.³ In addition, in 1-4% of cases, COPD is caused by a genetic disorder called alpha-1 antitrypsin deficiency.³

In addition, 6% of people with asthma go on to develop Asthma COPD Overlap Syndrome (ACOS), in which “insufficient airway reversibility” results, typically after “a period of 21-33 years” living with asthma. ⁴ If asthma is uncontrolled with medications, they can undergo “remodeling” over time, impairing the airways ability to return to a non-narrowed state—non-reversible airway obstruction is defined as COPD, and indeed, can be caused simply by having asthma.⁴

Can we please stop COPD shaming?

I’ve had asthma advocates sit beside me at conferences saying those very words I wrote above—“Well, at least I didn’t cause my disease”. These words don’t help anybody. Like type 2 diabetes—in which people again encounter the same words about it being “their fault”—without a genetic predisposition, people might not develop either COPD or type 2 diabetes, regardless of lifestyle factors. That’s right—without a genetic predisposition, those with COPD may also not have developed their disease, even if they smoked.

The reality is we are all living with diseases that need to be monitored, treated, and require better treatments. We need each other to strengthen the patient voice and share our experiences. We should be in this together. And every time someone casts blame on another for their disease, we’re perpetuating the stigma that has no need to exist and helps no one want to better themselves. We also have no way to know a person’s story just by looking at them—even if someone says they have COPD, there may be a much longer story they just don’t feel like telling.

Changing the way we think

We need to accept one another for who we are and where we’re at. Changing our thinking on diseases that may be linked to lifestyle are a big step towards that: if you don’t know a person’s whole story—and even if you do—maybe it’s time to take a step back and not even internalize within yourself negative connotations about their disease. We are all worth more than that.