ArticlePloS one2016
COPD in Nonsmokers: Reports from the Tunisian Population-Based Burden of Obstructive Lung Disease Study.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Efficacy and Safety of Traditional Chinese Medicine in Treating Chronic Obstructive Pulmonary Disease with Osteoporosis: A Systematic Review and Meta-Analysis.International journal of chronic obstructive pulmonary disease · 2026Pooled it
- Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis.BMC public health · 2024Pooled it
- Risk factors for chronic obstructive pulmonary disease in never-smokers: A systematic review.The clinical respiratory journal · 2022Pooled it
- Assessment of comorbidities and prognosis in patients with COPD diagnosed with the fixed ratio and the lower limit of normal: a systematic review and meta-analysis.Respiratory research · 2020Pooled it
- Joint statement for the diagnosis, management, and prevention of chronic obstructive pulmonary disease for Gulf Cooperation Council countries and Middle East-North Africa region, 2017.International journal of chronic obstructive pulmonary disease · 2017Guideline
- Characterisation of chronic obstructive pulmonary disease (COPD) in never-smokers and ever-smokers from a population-based cohort.BMJ open respiratory research · 2026Observational
- Distinct risks of exacerbation and lung function decline between never-smokers and ever-smokers with COPD.BMC pulmonary medicine · 2025Article
- Burden of chronic obstructive pulmonary disease in Ghana and globally from 1990 to 2021, with projections through 2050: a systematic analysis based on the Global Burden of Disease Study 2021.Frontiers in medicine · 2025Article
- Development and validation of a predictive model for COPD: a multicenter study.Frontiers in medicine · 2025Article
- The Role of Active and Passive Smoking in Chronic Obstructive Pulmonary Disease and Systemic Inflammation: A 12-year Prospective Study in China.Journal of epidemiology and global health · 2024Article
- COPD in Never-Smokers: BOLD Australia Study.International journal of chronic obstructive pulmonary disease · 2024Article
- Analysis of COPD: Distinguishing Characteristics and Management of Smoking vs Never Smoking Patients.International journal of chronic obstructive pulmonary disease · 2024Article
- Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Users of Primary Health Care Facilities in Morocco.International journal of chronic obstructive pulmonary disease · 2024Observational
- Value of inferior vena cava collapsibility index as marker of heart failure in chronic obstructive pulmonary disease exacerbation.BMC cardiovascular disorders · 2023Article
- Association of mannose binding lectin with chronic obstructive pulmonary disease susceptibility and its clinical outcomes.Molecular biology reports · 2023Article
- Prevalence and determinants of chronic respiratory diseases in adults in rural Sudan.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Early Origins of Chronic Obstructive Pulmonary Disease: Prenatal and Early Life Risk Factors.International journal of environmental research and public health · 2023Review
- Comparison of demographic, clinical, spirometry, and radiological parameters between smoking and non-smoking COPD patients in rural Gujarat, India.Journal of family medicine and primary care · 2021Article
- OscillococcinumDrugs in context · 2021Article
- Exposure to Air Pollution Exacerbates Inflammation in Rats with Preexisting COPD.Mediators of inflammation · 2020Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundIt's currently well known that smoking and increasing age constitute the most important risk factors for chronic obstructive pulmonary disease (COPD). However, little is known about COPD among nonsmokers. The present study aimed to investigate prevalence, risk factors and the profiles of COPD among nonsmokers based on the Tunisian Burden of Obstructive Lung Disease (BOLD) study.
methods807 adults aged 40 years+ were randomly selected from the general population. We collected information about history of respiratory disease, risk factors for COPD and quality of life. Post-bronchodilator spirometry was performed for assessment of COPD. COPD diagnostic was based on the post-bronchodilator FEV1/FVC ratio, according to the Global Initiative for Obstructive Lung Disease (GOLD) guidelines. The lower limit of normal (LLN) was determined as an alternative threshold for the FEV1/FVC ratio. RESULTS AND
conclusionsAmong 485 nonsmokers, 4.7% met the criteria for GOLD grade I and higher COPD. These proportions were similar even when the LLN was used as a threshold. None of the nonsmokers with COPD reported a previous doctor diagnosis of COPD compared to 7.1% of smokers. Nonsmokers accounted for 45.1% of the subjects fulfilling the GOLD spirometric criteria of COPD. Nonsmokers were predominately men and reported more asthma problems than obstructed smokers. Among nonsmokers significantly more symptoms and higher co-morbidity were found among those with COPD. Increasing age, male gender, occupational exposure, lower body mass index and a previous diagnosis of asthma are associated with increased risk for COPD in nonsmokers. This study confirms previous evidence that nonsmokers comprise a substantial proportion of individuals with COPD. Nonsmokers with COPD have a specific profile and should, thus, receive far greater attention to prevent and treat chronic airway obstruction.
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Registered trials
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