Nepal Demographic Health Survey 2016 reported that 27 per cent of Nepali males and six per cent females smoke. High level outdoor and indoor pollution is another factor Kathmandu, November 23 Poor air quality, smoking, dust, use of biomass fuels for cooking and heating are some of the causes for chronic obstructive pulmonary disease in the country, according to health practitioners. A research conducted by Nepal Health Research Council with support from the Ministry of Health and Population revealed that chronic obstructive pulmonary disease was the most prevalent (11.7 per cent) non-communicable disease, followed by diabetes mellitus (8.5 per cent), chronic kidney disease (6 per cent) and coronary artery disease (2.9 per cent) among Nepalis. “The primary cause of chronic obstructive pulmonary disease is smoking (including second-hand or passive exposure),” said Dr Phanindra Prasad Baral, chief of Non-communicable Diseases and Mental Health at Epidemiology and Disease Control Division. Nepal Demographic Health Survey-2016 reported that 27 per cent of Nepali males and six per cent of females smoked tobacco. Higher level of indoor and outdoor pollution is another leading cause of COPD. The NHRC report revealed that the prevalence of COPD was higher in men, 12.6 per cent compared to 11 per cent in women. Biomass fuels used by women for cooking accounted for high prevalence of COPD among non-smoking women. “Though the prevalence of the disease is more in men, women are at higher risk of losing life of being disabled. Use of traditional cooking stoves, poorly ventilated homes, indoor air pollution, women spending more time in the kitchen for household chores and delayed hospital visits are some factors leading to death or disability,” said Tara Ballav Adhikari, a student at Aarhus University, Denmark, who is conducting research on community based management of COPD in Nepal. According to Nepal Demographic Health Survey-2016, about two-thirds of households (66 per cent) use solid fuel for cooking, and this practice is more common in rural households (88 per cent) than urban households (52 per cent). The prevalence of COPD varied considerably province-wise. It ranged from six per cent in Gandaki Province to 25.1 per cent in Karnali Province. “People living in rural areas are more prone to COPD as they are exposed to smoke,” said Adhikari. Thirty-one per cent households were exposed to tobacco smoke daily (34 per cent) in rural areas and 30 per cent in urban areas), according to NDHS. “As the Nepali population ages, the burden of COPD is likely to increase because with increasing age, the incidence as well as death and disability increases,” added Adhikari. The burden of COPD will increase in the country if effective measures are not taken to identify the disease and provide effective treatment. “Use of improvised kitchen stoves, pollution control and quitting smoking will help prevent COPD,” Adhikari said. Shortness of breath, specially during physical activities, wheezing, chest tightness, chronic cough, which may produce sputum, are some of the symptoms of COPD. Treatment will relieve symptoms, improve quality of life and reduce risk of death, Adhikari added.