Chronic Obstructive Pulmonary Disease and Smoking in India: A Meta-Analysis

ABSTRACT

WHO estimates show chronic obstructive pulmonary disease [COPD] as a growing major global cause of morbidity as well as mortality. COPD associated mortality is projected to grow by 160% in the decades ahead. Much of this projection holds pansexual cigarette smoking, improved life expectancy, bulging ger-iatric population and high levels of small particle pollution, as major causes behind increase in COPD case burden.The aim of themeta-analysis was to investigate association between COPD and risk factors by pooled and subgroup analysis. The publications listed in the NCBI PubMed and Cochrane library were searched using the following combination of the key words “COPD”; “smokers”; “health”; “risk” or “fac-tors”; “diagnostic”; “burden”; “exposure”; “disease” or “prevalence” or “morbidity” or “mortality”; “tobac-co”; “smoking”; “smoke”, “India”. Random effects meta-analysis was applied to generate pooled SMD by using CMA software.Main risk factors for COPD were higher age [SMD=0.53, CI= (0.0018-1.05)], total pack years of Smoking [SMD=13.83, CI (10.060-17.616)], FEV1 [SMD=-13.15, CI= (-16.234 to -10.085) and FEV/FVC ratio [SMD=0.915.CI= (0.767-1.063)]. Higher age, smoking, low values of FEV1 and FEV/FVC ratio is directly associated with high risk of COPD. The finding of the study shows evidence of smoking history in terms of pack of years as a major risk factor for COPD prevalence.