MANY smokers who have signs of irreversible lung damage fail to seek treatment because they attribute their breathlessness to other causes.

They do not seek help even if their condition is so bad it prevents them sleeping, dressing, exercising and even having sex. In the first survey of its kind to look at breathlessness among people at risk from chronic obstructive pulmonary disease (COPD), 2300 smokers or ex-smokers in the UK, US, France and Germany were interviewed. One in five said they suffered from breathlessness when walking up a short flight of stairs, but a third did not attribute it to smoking but other causes such as growing older or being unfit. "COPD has a very slow onset," said David Price, professor of primary care respiratory medicine at Aberdeen University who developed the survey. "Many people just cut back on their activities so they don't become breathless. It is not normal to get breathless walking up a flight of stairs. "The survey gives an idea of how serious breathlessness is in this population." More than one in 10 surveyed said breathlessness prevented them from coping with tasks such as dressing and leaving the house. About a quarter of those said that their breathlessness either completely or frequently dictated their daily activities. Problems caused included panicking when unable to breathe and having problems taking part in exercise, sport and sex. COPD is a slowly progressive disease that causes irreversible lung damage. Symptoms include breathlessness, coughing and sputum production. According to the World Health Organisation, smoking is the biggest risk factor for the condition, which is the world's fourth-biggest killer per year, alongside HIV-Aids. In the survey, sufferers also reported mixed success from medical advice; almost two-thirds had consulted a doctor, but only about half of those had been given a diagnosis. "There were large country variations in diagnoses, but it is difficult to know if this is a result of cultural or language differences in disease terminology or whether some diagnoses were inaccurate," Professor Price said. Among its other findings, the survey highlighted national differences. Twice as many people in Germany thought smoking had nothing to do with breathing problems. US doctors gave the largest number of diagnoses of COPD. The French were the least likely to consult a doctor about their breathing. Britons reported the most severe mobility problems caused by breathlessness.

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