COPD is the fourth leading cause of death globally, according to the World Health Organization, and it is directly linked to a lower life expectancy, even in adult patients with COPD who have never smoked.
That’s according to the paper, “Life Expectancy in Chronic Obstructive Pulmonary Disease,” published in JAMA Internal Medicine and presented at the American Thoracic Society 2026 International Conference in Orlando, Florida.
“Despite the strong epidemiologic evidence for high mortality due to COPD, there have been limited efforts to quantify the [years of life lost] and life expectancy in COPD,” the researchers wrote. These estimations can help communicate better with policymakers and patients who are interested in lifespan to make informed decisions about their care.
The cohort study included data from 45,886 participants enrolled in eight different U.S. studies. The information came from the National Heart, Lung and Blood Institute Pooled Cohorts Study that harmonized data from all sources. The mean age of the population was 52.4 years. A little more than half of participants (56%) were female and most (59.1%) were non-Hispanic white.
Just under half of the participants (48.8%) were lifetime never-smokers; 21% were current smokers, and 30.2% were former smokers at baseline. COPD was present at baseline in 17.6% of participants. The patients were at varying stages of COPD, as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD):
- 4,166 were at GOLD stage one
- 3,227 were at GOLD stage two
- 561 were at GOLD stage three
- 106 were at GOLD stage four
Over a median follow-up of 15.2 years, 13,869 participants died, with survival rates progressively decreasing with each worsening GOLD stage. Current smokers had a lower survival rate than former and never-smokers across all disease stages.
Ultimately, the researchers found that COPD was associated with an average of two years of life lost, with up to 7.2 years lost with very severe disease. COPD is increasingly detected in never smokers, and the reduction of life expectancy was similar to that noted in ever-smokers. The years of life lost with moderate-to-very severe COPD were comparable to those with hypertension and diabetes.
“This study suggests that COPD is associated with lower life expectancy, even in lifetime nonsmokers and is lower with worsening disease stages,” the researchers wrote. “These results highlight the premature mortality and life expectancy associated with COPD, a disease that is increasingly recognized as a disease [that does not only affect] older individuals.”
