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.
But there are likely other factors at play in the development of COPD, such as a genetic susceptibility to the disease, because only about 20 to 30 percent of smokers may develop COPD. Other irritants can cause COPD, including cigar smoke, secondhand smoke, pipe smoke, air pollution and workplace exposure to dust, smoke or fumes. Alpha-1-antitrypsin deficiency In about 1 percent of people with COPD, the disease results from a genetic disorder that causes low levels of a protein called alpha-1-antitrypsin.