Comparison of Clinico- Demographic and Lung Spirometry Profile Between Non- Smoker versus Smoker COPD Patients

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality worldwide, with smoking being the leading risk factor. However, non-smokers, particularly those exposed to biomass fuel, occupational hazards, or second-hand smoke, also contribute significantly to the disease burden. This study aims to compare the clinico-demographic and lung spirometry profiles between non-smoker and smoker COPD patients, highlighting the differences in risk factors, symptom presentation, and disease severity. Materials and Methods: This cross-sectional study was conducted at a tertiary care center, including 200 COPD patients diagnosed through clinical features and spirometry. Patients were divided into two groups: smokers and non-smokers. Data on clinical symptoms, demographic factors, and lung function (via spirometry and GOLD classification) were collected. Non-smokers were those exposed to biomass or occupational risks, while smokers had a smoking history of at least 10 pack-years. Statistical analyses were performed to compare the two groups, with a p-value <0.05 considered significant. Results: In our study, 67% of the COPD patients were smokers, and 33% were non-smokers. The majority of smokers (99 out of 134) were classified as GOLD 3, with 17 in GOLD 4, while non-smokers were primarily in GOLD 3 (39 out of 66), with only 2 in GOLD 4 (p < 0.001). Non-smokers had significant risk factors like biofuel exposure (71.2%), second-hand smoke (15.2%), and underlying causes (13.6%). Smokers experienced more severe symptoms, including cough (102 out of 134), sputum (73), and chest tightness (42), compared to non-smokers (p-values ranging from 0.011 to 0.034). Additionally, 116 smokers had 3-5 acute exacerbations compared to 44 non-smokers (p = 0.001). Smokers also had a higher mean CAT score (31.43 ± 4.204) than non-smokers (29.17 ± 4.508, p = 0.001). Lastly, socioeconomic status showed a significant difference, with most smokers from lower classes (p < 0.001). Conclusion: Our study demonstrates significant differences between smoker and non-smoker COPD patients, with smokers exhibiting more severe lung function impairment, higher symptom burden, and frequent exacerbations. Non-smokers were primarily affected by biofuel exposure and environmental factors, indicating the need for targeted interventions in both groups to manage and prevent COPD.