November is COPD Awareness Month, and one Alberta woman is sharing her experience with the disease in hopes of warning others about the damage smoking can do to your lungs. Jill Bradford Green, 80, was diagnosed with chronic obstructive pulmonary disease about a decade ago. She says her family doctor had warned her about the risks of smoking, but at the time, she wasn’t ready to quit. “I thought I was invincible,” Green said. “I worked out at the gym, and I used to come out of a pretty good workout, sit in the car and have a cigarette — but I’ve come to realize that was a big mistake.” For years, Green managed her condition with medication. Then, about five years ago, a sudden worsening of her symptoms landed her in hospital. “I had a sudden exacerbation in my lungs, and everything changed abruptly,” she said. “I lost a lot of confidence in myself.” Since then, Green has relied on supplemental oxygen and has had to give up activities she once loved, like riding her motorcycle and spending long hours gardening. A disease that can go unnoticed COPD is a chronic lung disease that makes it increasingly difficult to breathe. It involves damage to the lungs and airways, including a loss of elasticity in the small airways, making it harder to move air in and out. Dr. Grace Lam, an adult respirologist, clinician scientist and assistant professor at the University of Alberta, says symptoms can develop gradually, leading some people to dismiss them as a normal part of smoking or getting older. “People who smoke might feel it’s entirely natural to be short of breath, have a ‘smoker’s cough’ or (are) simply out of shape,” Lam said. “But these symptoms can also be signs of a disease that needs medical attention.” Lam says COPD can only be diagnosed through lung function testing. Smoking is a major risk factor, but a person should not be diagnosed based on smoking history alone. The impact is significant across the country. According to the Canadian Institute for Health Information (CIHI), there were more than 93,000 hospitalizations for COPD and bronchitis in Canada in 2017–18 — nearly 90,000 admissions in a single year. More recent CIHI data shows COPD and bronchitis remained the second most common reason for hospitalization in Canada in 2024–25, with an average hospital stay of seven days. Alberta’s regional divide The burden of COPD is not evenly distributed across the province. A study conducted by Lam and fellow researchers examining 265,589 people living with COPD in Alberta found significant differences in health care use and outcomes during the COVID-19 pandemic. The research found COPD-related emergency department visits dropped by 39 per cent during the pandemic, while deaths among people with COPD increased by 21 per cent. Separate data from CIHI found COPD prevalence in Alberta’s North Zone was more than twice the rate in the Calgary Zone. Lam says access to specialists may be one factor contributing to those differences. “There is a lack of respirologists north of Edmonton,” she said. She also says rates of hospitalization, emergency department visits and mortality among people with COPD have been creeping up, making access to diagnosis and treatment especially important. “It’s very topical right now in November with more prevalent COVID infections, RSV and influenza in patients with COPD, for example, that certainly lead to significantly great risk of severe exacerbation,” Lam said. “In the last flu season, there has been extensive reporting on the reduction of vaccination rates when we compare Alberta to the rest of Canada, and when we compare last season with the 2024-25 season, there is also within the province of Alberta a drop in vaccination rates.” In a statement to CTV News, Alberta’s Ministry of Primary and Preventative Health Services says the province supports people living with COPD through Primary Care Alberta. The ministry says those services include respiratory testing, specialist services, pulmonary rehabilitation, patient education and self-management supports. It also says early identification and appropriate diagnosis are supported through clinical guidance for primary care providers, access to respiratory testing and referral and specialist advice processes. “Alberta is committed to helping people living with chronic obstructive pulmonary disease (COPD) manage their condition and receive the care they need,” the ministry said. Preventing flare-ups and slowing progression For people living with COPD, respiratory infections can trigger sudden flare-ups, known as exacerbations. Lam says viral infections, including those that circulate during cold and flu season, are common triggers. Some exacerbations are relatively mild, while others can become serious enough to require an emergency room visit, hospitalization or intensive care. Severe flare-ups can also put stress on the rest of the body. Reduced oxygen levels and the strain on the cardiovascular system can increase the risk of heart and blood vessel complications. Lam recommends staying up to date on vaccinations, including those for influenza, COVID-19 and RSV. She also encourages patients to follow their prescribed inhaler treatment and take precautions when air quality is poor. Henry Roberts, managing director of the COPD Association, known as COPD Canada, says early diagnosis is another important part of managing the disease. He says spirometry, a simple breathing test that measures how much air someone can move in and out of their lungs, can help identify COPD before it reaches more advanced stages. Pulmonary rehabilitation can also help people living with COPD learn breathing techniques and strategies to manage their symptoms. “The biggest thing though is that if you’re a smoker, you should really quit and seek medical help,” Roberts said. He added it’s not just cigarettes, however, that are having an impact. “We’ve done a pretty good job of wrestling cigarette smoking to the ground over the years, but now we’re seeing the rise of vaping,” said Roberts. “Especially with the younger kids, our big concern is that we’re going to replace cigarette smoking having damage to lungs with vaping, damaging the lungs. So, there’s a there’s quite a movement now to introduce a program called the Smoke Free Generation.” A message Jill wishes she had heard sooner For Green, the effects of COPD have been difficult to accept. She describes herself as an “Energizer bunny” before her health declined. Now, she has less energy and says her lung function is down to about 35 to 40 per cent. She knows her condition is not expected to improve and says she has had to adjust to a very different pace of life. “It’s an insidious disease that you can’t run away from,” she said. “You just got to learn to manage it, but you could also learn to prevent it and the sooner you quit, the better off you are.” Green adds that she is especially aware of the risks when she sees someone smoking. “Every time I see a smoker, I want to say to them, ‘That’s killing you.’” She says if she could go back, she would make a different decision. “If I was a smoker today, I would quit — as much as I loved it.”
