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 cause of COPD is much more clear-cut. Smoking is the main cause and is attributed to about 85 to 90 percent of all COPD deaths. Exposure to air pollution, chemicals, and secondhand smoke can also cause it. In rare cases, a genetic defect called alpha-1 antitrypsin deficiency, or AAT, can lead to COPD.