Health and Me

Ishita Roy

Why COPD Is Now Affecting People in Their 20s and 30s

<span><a href="https://www.healthandme.com/health/chronic-obstructive-pulmonary-disease">Chronic obstructive pulmonary disease</a></span> (<span>COPD</span>) has long been seen as a condition of older adults, typically tied to years of smoking. But across India, pulmonologists are increasingly diagnosing it in people in their 20s and 30s. This shift, experts say, reflects a deeper and more troubling change: young adults are growing up and living in environments where the lungs never truly get a chance to breathe clean air.

<h2>A Shift From “Smoker’s Disease” to “Exposure Disease”</h2>

The biggest change is the cause itself. As Dr. Raja Dhar, Director &amp; HOD, Pulmonology, CK Birla Hospitals, CMRI Kolkata, explains, “COPD is increasingly becoming an ‘exposure disease’ rather than a ‘smoker’s disease.’ In India, non-smoking COPD is numerically a much larger problem.”

This exposure begins early—sometimes in childhood. 

Dr. Dhar highlights how even limited exposure can have lifelong consequences: “Severe airway obstruction can be traced back to just six to seven years of biomass smoke exposure in a poorly ventilated kitchen during a child’s formative years.”

Dr. Harshil Alwani, Consultant – Pulmonology, CK Birla Hospitals, Jaipur, also points to the changing risk profile. According to him, “newer epidemiological data show that non-smoking drivers—especially air pollution and occupational exposures—are playing a disproportionately large role in younger people.” He adds that rapid urbanisation means more young adults are chronically breathing polluted air from childhood onwards.

Improved diagnosis and greater awareness also mean younger patients with persistent symptoms are now being evaluated more often, he notes.

<h2>Beyond Smoking: The Real Culprits Behind Early COPD</h2>

Both experts agree that polluted air is the biggest trigger today. Dr. Alwani explains that long-term exposure to PM₂.₅ is directly linked to lung decline and COPD. “Recent research shows that temperature and humidity modulate the harmful effect of PM₂.₅, making COPD risk worse under certain climatic conditions,” he says.

Dr. Dhar adds that India’s air quality is deteriorating nationwide: “Ambient outdoor air pollution is a severe risk, as air quality across 98% of India is worse than WHO standards.”

Household pollution remains a massive issue. Biomass fuel used for cooking is, as Dr. Dhar puts it, “the largest non-smoking contributor, resulting in numbers approximately three times that of smoking-related COPD.”

Young adults working in construction, mining, welding, or factory settings face daily exposure to dust, fumes, and chemicals. Dr. Alwani notes that such environments “carry a significantly increased risk.”

Recurrent infections can impair lung development and reduce lung reserve, making early-onset disease more likely.

Conditions like alpha-1 antitrypsin deficiency, though rare, still contribute when combined with environmental triggers.

<h2>Delhi’s Winter Pollution: A Direct Route to Lung Damage</h2>

Every winter, Delhi’s smog becomes a health emergency. According to Dr. Dhar, “High winter pollution, particularly hazardous levels of PM2.5, acts as a chronic, low-grade chemical burn on the young respiratory system.”

Dr. Alwani adds that winter inversion traps pollutants closer to the ground, amplifying PM₂.₅’s damage.

Vaping and e-cigarettes, widely perceived as harmless, have added a new layer of risk. Dr. Alwani warns, “Vaping is not benign. Its aerosols contain volatile compounds, heavy metals, and ultrafine particles that trigger inflammation and oxidative stress—central pathways to COPD.”

Dr. Dhar echoes this concern: “Any inhalation of heated chemical aerosols is a significant lung irritant and pro-inflammatory agent.”

<h2>Symptoms Young Adults Should Never Ignore</h2>

Doctors urge young adults not to dismiss symptoms like:

<ul><li>Persistent cough</li><li>Breathlessness during routine activity</li><li>Wheezing or chest tightness</li><li>Frequent colds or bronchitis</li><li>Fatigue or reduced stamina</li></ul>

Early spirometry can dramatically change outcomes. As Dr. Dhar puts it, “Early intervention allows us to remove the source of exposure and start therapy, which can effectively preserve the patient’s remaining lung function.”

Dr. Alwani adds that catching the disease early can “significantly slow further lung damage” and prevent long-term complications.

Health Conditions A-Z

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Chronic Obstructive Pulmonary Disease

health and wellness

COPD

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respiratory diseases

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Chronic obstructive pulmonary disease (COPD) has long been seen as a condition of older adults, typically tied to years of smoking. But across India, pulmonologists are increasingly diagnosing it in people in their 20s and 30s. This shift, experts say, reflects a deeper and more troubling change: young adults are growing up and living in environments where the lungs never truly get a chance to breathe clean air.A Shift From “Smoker’s Disease” to “Exposure Disease”The biggest change is the cause itself. As Dr. Raja Dhar, Director & HOD, Pulmonology, CK Birla Hospitals, CMRI Kolkata, explains, “COPD is increasingly becoming an ‘exposure disease’ rather than a ‘smoker’s disease.’ In India, non-smoking COPD is numerically a much larger problem.”This exposure begins early—sometimes in childhood. Dr. Dhar highlights how even limited exposure can have lifelong consequences: “Severe airway obstruction can be traced back to just six to seven years of biomass smoke exposure in a poorly ventilated kitchen during a child’s formative years.”Dr. Harshil Alwani, Consultant – Pulmonology, CK Birla Hospitals, Jaipur, also points to the changing risk profile. According to him, “newer epidemiological data show that non-smoking drivers—especially air pollution and occupational exposures—are playing a disproportionately large role in younger people.” He adds that rapid urbanisation means more young adults are chronically breathing polluted air from childhood onwards.Improved diagnosis and greater awareness also mean younger patients with persistent symptoms are now being evaluated more often, he notes.Beyond Smoking: The Real Culprits Behind Early COPDAir PollutionBoth experts agree that polluted air is the biggest trigger today. Dr. Alwani explains that long-term exposure to PM₂.₅ is directly linked to lung decline and COPD. “Recent research shows that temperature and humidity modulate the harmful effect of PM₂.₅, making COPD risk worse under certain climatic conditions,” he says.Dr. Dhar adds that India’s air quality is deteriorating nationwide: “Ambient outdoor air pollution is a severe risk, as air quality across 98% of India is worse than WHO standards.”Indoor PollutionHousehold pollution remains a massive issue. Biomass fuel used for cooking is, as Dr. Dhar puts it, “the largest non-smoking contributor, resulting in numbers approximately three times that of smoking-related COPD.”Occupational HazardsYoung adults working in construction, mining, welding, or factory settings face daily exposure to dust, fumes, and chemicals. Dr. Alwani notes that such environments “carry a significantly increased risk.”Childhood Lung InfectionsRecurrent infections can impair lung development and reduce lung reserve, making early-onset disease more likely.Genetic FactorsConditions like alpha-1 antitrypsin deficiency, though rare, still contribute when combined with environmental triggers.Delhi’s Winter Pollution: A Direct Route to Lung DamageEvery winter, Delhi’s smog becomes a health emergency. According to Dr. Dhar, “High winter pollution, particularly hazardous levels of PM2.5, acts as a chronic, low-grade chemical burn on the young respiratory system.”Dr. Alwani adds that winter inversion traps pollutants closer to the ground, amplifying PM₂.₅’s damage.The Vaping ProblemVaping and e-cigarettes, widely perceived as harmless, have added a new layer of risk. Dr. Alwani warns, “Vaping is not benign. Its aerosols contain volatile compounds, heavy metals, and ultrafine particles that trigger inflammation and oxidative stress—central pathways to COPD.”Dr. Dhar echoes this concern: “Any inhalation of heated chemical aerosols is a significant lung irritant and pro-inflammatory agent.”Symptoms Young Adults Should Never IgnoreDoctors urge young adults not to dismiss symptoms like:Persistent coughBreathlessness during routine activityWheezing or chest tightnessFrequent colds or bronchitisFatigue or reduced staminaWhy Early Diagnosis MattersEarly spirometry can dramatically change outcomes. As Dr. Dhar puts it, “Early intervention allows us to remove the source of exposure and start therapy, which can effectively preserve the patient’s remaining lung function.”Dr. Alwani adds that catching the disease early can “significantly slow further lung damage” and prevent long-term complications.