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.
Smoking. The primary cause of chronic obstructive pulmonary disease (COPD) is tobacco smoke (including second-hand or passive exposure). WHO estimates that in 2005 5.4 million people died due to tobacco use. Tobacco-related deaths are projected to increase to 8.3 million deaths per year by 2030.