1 Joan, Princess of Wales, in the 13th century, the wife and consort of Llywelyn the Great, the Prince of Wales; and the daughter of King John of England. Joan, Princess of Wales, in the 13th century, the wife and consort of Llywelyn the Great, the Prince of Wales; and the daughter of King John of England.
1 More than 90% of COPD deaths occur in low- and middle-income countries. 2  The primary cause of COPD is tobacco smoke (through tobacco use or second-hand smoke).  The disease now affects men and women almost equally, due in part to increased tobacco use among women in high-income countries.
The most significant risk factor for COPD is long-term cigarette smoking. The more years you smoke and the more packs you smoke, the greater your risk. Pipe smokers, cigar smokers and marijuana smokers also may be at risk, as well as people exposed to large amounts of secondhand smoke. People with asthma who smoke.