Chronic obstructive pulmonary disease (COPD)

COPD is a long-term lung condition that can cause breathlessness, coughing, mucus (sputum or phlegm) and sometimes wheezing. COPD is treatable. The most important way to treat it is to stop smoking if you are a smoker.

Overview of COPD

You can think about your lungs as being made up of tubes and sponges. The tubes bring air in from the outside world. Oxygen from the air transfers to your bloodstream in the spongy part of your lungs (alveoli).

COPD makes the tubes narrow and full of mucus (this is called chronic bronchitis) and damages the spongy parts (this is called emphysema).

People with COPD are breathless because they have to work hard to breathe through narrowed tubes and stiff sponges.

Prime Medic video: Understanding chronic obstructive pulmonary disease (COPD) — YouTube (external link)

Cause of COPD

COPD is much more common in people who smoke or have smoked in the past than people who have never smoked. COPD can also run in families.

Long-term exposure to second-hand smoke or air pollution can also cause COPD. Inhaling fumes, dust or smoke during your line of work is another cause.

Symptoms of COPD

Often the symptoms of COPD take a long time to appear. You could have the condition for many years and not know about it. The symptoms include:

  • a daily cough that produces mucus
  • a lot of mucus in your throat in the mornings
  • wheezing
  • shortness of breath
  • lack of energy
  • frequent chest infections.

If you have any of these symptoms and have been a smoker, talk to your healthcare provider.

Diagnosing COPD

You may need several tests to diagnose COPD and rule out other causes of your shortness of breath.

A breathing test known as spirometry is the best way to tell if you have COPD and to work out how bad it is. This is a simple test. You blow into a machine that measures how well your lungs are working.

Spirometry — Asthma and Respiratory Foundation (external link)

There are several places where you can have the test. Your healthcare provider will refer you to the one that is most convenient for you.

Other tests you may have include:

  • pulse oximetry, which is a light probe on your finger to measure your blood oxygen. There is a difference between feeling short of breath and being short of oxygen
  • a chest x-ray to look for other possible causes of your shortness of breath
  • an ECG to check for heart issues
  • blood tests.

Treating COPD

While COPD cannot be cured, treatment can prevent it getting worse and help with your symptoms.

Pulmonary rehabilitation

A specialised exercise and education programme known as pulmonary rehabilitation is an important part of treatment. Classes teach you about COPD, how to manage it, and exercises you can do to improve your breathing. Talk to your healthcare provider about a local programme for you to attend.

COPD medications

The type of medication that is best for you will depend on how severe your COPD is and any other medical conditions you have.


People with COPD are often given inhalers, which are devices that deliver medication to your lungs. You may need several different inhalers depending on your symptoms and how severe they are. It is important to use your inhalers correctly for them to work. 

Inhalers — HealthInfo (external link)

Most inhalers for COPD open up your breathing tubes and reduce your breathlessness. There are many different inhalers that last for different lengths of time. Your healthcare provider will usually give you a short-acting reliever such assalbutamol (Ventolin). You should use this if you are breathless or about to do something that will make you breathless.

Your healthcare provider may also give you longer acting inhalers to use once or twice a day to keep your breathing tubes open.

Some people who have frequent flare-ups (exacerbations) may be given an inhaler preventer containing a low dose of a steroid such as fluticasone (Flixotide). But most people with COPD do not need this.

Antibiotics and prednisone

If you have a flare-up, you will normally be given antibiotics and sometimes prednisone (steroid tablets).

If your mucus (sputum or phlegm) has changed colour, you are producing more than usual and you are getting more breathless, antibiotics will help. Your healthcare provider may give you a stock of antibiotics to keep at home. You should use them according to your agreed COPD Management Plan (COPD Blue Card).

COPD Management Plan — Asthma and Respiratory Foundation (external link)

Starting antibiotics early can stop a flare-up getting worse. It can also reduce the time it takes to recover.

Medications that help loosen your mucus

These medications are called mucolytics. They help make your mucus easier to cough up. An example of a mucolytic is a syrup called bromhexine hydrochloride (Bisolvon), which you drink.

Other treatments

Many people think that oxygen is a treatment for breathlessness but this is incorrect. People get breathless because of the difficulty getting air in and out of lungs that are stiff with narrow breathing tubes. Giving extra oxygen does not help.

But some people have low oxygen levels all the time. These people are given oxygen to protect their hearts from the long-term effects of low oxygen.

If you have very severe COPD, you may be referred to see a chest specialist. There are operations and procedures that may help a small number of people who have very severe COPD but are otherwise well. This includes lung transplants.

Treatments given in hospital

Some people in hospital with a severe flare-up of COPD are treated for a short time with breathing support using a mask. If their oxygen level is very low, they will also be given oxygen.

Advanced COPD

COPD (chronic obstructive pulmonary disease) can often be managed for many years using modern therapies. But if you have complications or your lungs are getting worse, the treatments may be less effective.

Your treatment plan may to focus on giving you a good quality of life. Some treatments may become less important, and others may be added to help control your symptoms.

Advanced COPD — HealthInfo (external link)

Self care for COPD

If you have been diagnosed with COPD, you can stop it getting worse. It will not ever go away completely but there are things you can do to stay well and to make your symptoms less severe.

Be smokefree

This is the best way to reduce your symptoms, and prevent your condition getting worse. 

Physical activity

Keeping active is an important part of helping your breathing. 

Learn to manage flare-ups

Worsening symptoms like increased coughing, wheezing, breathlessness and a change in the colour of your sputum (phlegm) is called a flare up or exacerbation.

If you have developed a plan with your healthcare provider, you can start treating a flare-up at home.

Your plan will often include having a supply of antibiotics and prednisone (oral steroid tablets) that you can start taking. If you take them, make a note of what you have  taken and when. If you are following your plan and are not improving or are concerned, see your healthcare provider.

If you are getting better, see your healthcare provider a week after starting your antibiotics so they can assess your health and you can refill your emergency prescriptions.

It may take up to a month before you feel normal again. Continue to keep active to maintain your strength.

Learn to manage breathlessness

Finding ways to manage your breathlessness and the anxious feeling it can cause can allow you to enjoy more activities.

Though often frightening, it is important to know being breathless does not usually mean you are short of oxygen.

Simple measures such as having cold air blowing across your face from a fan and finding the right body position can help.

Learn good breathing control — Asthma and Respiratory Foundation (external link)


It is important to have an annual flu vaccine. If you have COPD, you are more likely to be seriously affected by catching the flu or getting a chest infection after the flu.

Flu (influenza) vaccine (internal link)

You should keep up to date with COVID-19 vaccine boosters.

COVID-19 boosters (internal link)

You should also get a pneumococcal vaccine that protects against a particular type of bacterial infection that can cause a serious lung infection. You may have to pay for this vaccine.

Pneumococcal vaccine (internal link)

Weight and nutrition

Keeping close to a normal weight (not too high, not too low) is good if you have COPD. Some people with COPD have difficulty putting weight back on, especially after infections.

Talk to your healthcare or your dietitian for help get to and keep a healthy weight.

Keeping your home warm and dry

It is important for your health to keep your home warm and dry.

Keeping your home warm and dry has information about subsidies and support for heating and insulation.

The Asthma and Respiratory Foundation NZ has some useful information about keeping your home healthy.

Healthy homes —Asthma and Respiratory Foundation NZ (external link)