Why do most people mistake COPD for asthma? Pulmonologist explains why that delay can be deadly

Misunderstanding COPD and asthma can be risky. Recognising the difference in the condition, treatment options, and the need for early intervention is important.

Many people mix up asthma and chronic obstructive pulmonary disease (COPD). However, they need different treatments. It is important to obtain an accurate diagnosis because a mistake can lead to ineffective treatment. According to a 2017 report from the National Healthcare Quality Reporting System (NHQRS), about 450,000 people in Ireland have been diagnosed with asthma by a doctor. Additionally, around 500,000 people over 40 have COPD. Still, only half of them have received a diagnosis, according to the National Heart, Lung, and Blood Institute.

Are COPD and asthma similar?

How can doctors tell the difference between asthma and COPD? (Shutterstock)

By Tavishi Dogra

Tavishi Dogra is a Deputy Chief Content Producer, Health & Wellness, at Hindustan Times. She has over 9 years of experience writing about fitness, nutrition, and mental well-being, translating medical research and expert insights into practical advice readers can trust.

Career journey and experience
Tavishi began her health journalism journey in 2017, and has since reported for RSTV, Financial Express, Jagran, HT Media Labs and Zee. She joined Hindustan Times to simplify wellness subjects by cutting through jargon.

From decoding health trends and interviewing doctors to testing fitness routines herself, Tavishi always approaches content with one filter: “Will this help someone make a better decision today?”

Subject expertise
With 9+ years tracking India’s health conversations, Tavishi knows the gap between clinical advice and daily life. She knows fads from fundamentals and curates science-backed, expert-recommended solutions.

In fitness, she breaks down bodyweight training, recovery, and posture fixes for desk-bound readers. In nutrition, she translates guidelines into affordable, desi meal tweaks. In mental well-being, she focuses on stigma-free, actionable tools — all backed by research, expert input, and lived context.

Education and professional background
Tavishi holds a Master’s degree in Journalism and Mass Communication and began her career reporting on public affairs for broadcast. Those early years in policy and TV shaped how she writes today: fast, factual, and human-first.

Editorial Philosophy
I write with one single goal: To simplify health in a world full of noise by finding what’s actually doable, safe, and evidence-based for my readers. I test claims against research and user experiences. When all else fails, I speak to the expert who sees 50 patients a day, not the one with the most followers.

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At first glance, asthma and COPD seem similar. "Both involve the lungs and share symptoms such as coughing, wheezing, and shortness of breath", Pulmonologist Dr Rajendra Saini, Manipal Hospital, Ghaziabad, tells Health Shots. Without a proper medical diagnosis, people often confuse these two different diseases and group them under “lung issues.”

Environmental factors, including allergens, air pollution, and physical activity, are the primary triggers of asthma. Its symptoms can come and go, often making asthma feel under control between episodes. "In contrast, COPD is a long-lasting disease that gets worse over time and is mostly irreversible. It usually results from long-term exposure to harmful substances, such as cigarette smoke, air pollution, and industrial irritants," says the expert. The symptoms of COPD are steady and tend to worsen, rather than appearing and disappearing.

Confusing asthma with COPD can be problematic. This misunderstanding may cause some people to use asthma inhalers without getting a complete medical check-up. "Many patients don't realise that asthma can often be managed and sometimes even reversed", says the doctor. At the same time, COPD is a progressive illness that needs a very different approach to understanding and treatment.

How does COPD damage the lungs?

Chronic Obstructive Pulmonary Disease harms the lungs in quiet ways. It mainly includes two conditions: emphysema and chronic bronchitis. These conditions differ, but both lead to similar problems: persistent inflammation and obstructed airflow.

• Emphysema: This condition hurts the walls of the tiny air sacs (alveoli) in the lungs. "As a result, the body struggles to get enough oxygen, leading to difficulty in breathing", says the doctor.
• Chronic bronchitis: "Chronic bronchitis happens when the airways in the lungs become irritated and inflamed for a long time", shares the expert. This leads to excessive mucus production and more frequent coughing.

Mistaking COPD for asthma can lead to serious disappointment. "People should learn about the symptoms and signs of COPD. It's important not to rely only on personal stories or over-the-counter medicines", says Dr Saini. Further, he says regular check-ups with healthcare providers can help catch problems early. "If you or someone you know has breathing issues, reach out to healthcare professionals specialising in lung diseases", Dr Saini adds.

• The importance of early intervention: Getting treatment on time can slow the progression of COPD and help protect your lungs from further damage. When patients misunderstand their condition, they miss out on this critical opportunity to receive appropriate treatment.
• Different treatments for different conditions: Asthma inhalers help reduce inflammation for people with asthma, but they are not a complete solution. Chronic obstructive pulmonary disease (COPD) needs a customised treatment plan. This plan often includes corticosteroids, bronchodilators, and, in severe cases, lung volume reduction surgery or transplantation.
• Managing COPD exacerbations: Poor management of COPD can lead to serious complications, including respiratory failure and the need for mechanical ventilation. These issues often occur with severe asthma symptoms, which is why accurate diagnosis is so important.

(Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.)