Other recommendations include pneumococcal vaccination and yearly influenza vaccination to help reduce the risk of flare-ups; as of 2024 CDC and GOLD also recommend RSV vaccine for individuals above 60 years. A major goal of management is to reduce exposure to risk factors, including offering non-pharmacological treatments, such as help with stopping smoking. In cases of early, mild COPD, pulmonary rehabilitation may help to improve exercise capacity and quality of life. Higher-income families may use modern fuels such as natural gas or electricity, which cause less pollution and can lead to better health outcomes. Employers must provide a safe working environment, safeguarding employees through the use of ventilation, personal protection equipment, and regular air quality monitoring. Smoking, however, is highly addictive, and many smokers need further support.
In developing countries, poorly ventilated cooking and heating fires are a common cause of COPD, particularly for women and young children. These include exposure to indoor and outdoor pollutants, particulate matter, allergens, occupational exposure, and host factors. Up to 30% of COPD cases occur in people who have never smoked, and many heavy smokers do not develop COPD, so other factors also need to be considered. This causes significant or long-term inflammation that interacts with individual host factors.
NICE guidelines recommend the use of ICSs in people with asthmatic features or features suggesting steroid responsiveness. A triple inhaled therapy of LABA/LAMA/ICS improves lung function, reduces adrian casino symptoms and exacerbations and is seen to be more effective than mono or dual therapies. The combination of LABA+LAMA may reduce COPD exacerbations and improve quality-of-life compared to long-acting bronchodilators alone. Dual bronchodilator therapy (LABA+LAMA) is recommended for more severe symptoms.