Questions about COPD

The subeditor on my student paper would never let us end a headline with a question mark: the writer should be clear about what they are saying. Rupert Jones restates the question early in his leader on chronic obstructive pulmonary disease:1 ‘we need to know whether there are effective strategies to stop people with early disease progressing, and if so, how to detect the disease early’. Without providing convincing evidence he ends with what seems like an answer: ‘early diagnosis and active management can make real differences to the millions suffering to breathe’ but use of the word ‘can’ rather than ‘does’ veils continuing uncertainty. The list of pharmaceutical sponsors and commercial interests, creditably included, helps us to weigh his views appropriately. His ‘advice for any individual with early airflow obstruction needs to be that they may be at higher risk, but not that they are at the start of a relentlessly progressive disease whose course can only be changed by stopping smoking’. Leader writers and doctors should be clear about what we are saying: people — especially those with airflow obstruction — should stop smoking.

• © British Journal of General Practice, 2006.