Primary prevention

Avoidance of tobacco exposure (both active and passive measures) and toxic fumes are of invaluable importance in primary prevention of COPD. All smokers should be offered interventions aimed at smoking cessation, including pharmacotherapy and counselling. Although smoking cessation may be associated with minor short-term adverse effects such as weight gain and constipation, its long-term benefits are unquestionable.[46] For disease due to occupational exposures, primary prevention is achieved by elimination or reduction of exposures in the workplace. Public health measures such as congestion charging, high occupancy vehicle lanes, and promoting walking or cycling can be implemented to reduce harm from air pollution.[47]

Motivational interviewing overviewMotivational interviewing overview

Motivational interviewing: smoking cessation part 1Motivational interviewing: smoking cessation part 1

Motivational interviewing: smoking cessation part 2Motivational interviewing: smoking cessation part 2

Secondary prevention

Depending on local guidelines, patients should be vaccinated against influenza virus, Streptococcus pneumoniae, pertussis (whooping cough), varicella-zoster virus (shingles), and coronavirus disease 2019 (COVID-19).[2][172]

Vitamin D reduces the rate of moderate/severe exacerbations in patients with levels <25 nmol/L.[254][255] Levels should be checked in patients who are hospitalised with an exacerbation of COPD and supplementation should be given if levels are <25 nmol/L.[2]

Shielding measures (e.g., mask wearing, minimising social contact, and frequent hand washing) could be considered during winter months, alongside established COPD management, to help prevent exacerbations of COPD.[2]

Use of calcium supplementation and other medication may be necessary to prevent or treat osteoporosis in some patients, especially older women on long-term corticosteroid therapy. Bone density scans are done to evaluate progression of this condition.

Physical activity is recommended for all patients with COPD.[2]

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