COPD vs. Asthma: What’s the Difference?
Key takeaways:
Asthma and chronic obstructive pulmonary disease (COPD) are common lung conditions that cause shortness of breath and a cough.
Because the symptoms are similar, it can be hard to tell them apart. But there are features that can help distinguish them from each other.
People with asthma often suffer from allergies, and their symptoms usually start in childhood.
COPD typically develops later in life, and it’s caused by damage to the lungs from things like smoking or exposure to chemical fumes.
Table of contents
Chronic obstructive pulmonary disease (COPD) and asthma are lung diseases that affect millions of people worldwide. In the U.S., roughly 6% of adults have COPD and 8% of adults have asthma. And while COPD and asthma have some things in common, they’re not the same thing.
COPD is a long-term lung condition that makes it hard to breathe. COPD can damage the airways in your lungs as well as the tiny, round air sacs in your lung tissue. COPD isn’t a single disease: It’s a diagnosis that includes both emphysema and chronic bronchitis. Most people who have COPD are older adults who have smoked or were exposed to air pollution or chemical fumes for a long time.
Asthma is also a chronic lung condition that makes it hard to breathe. It causes inflammation in the airways of your lungs. People who have asthma are often sensitive to particles in the air that cause irritation or allergic reactions. People of all ages can have asthma, but it’s particularly common in children and younger adults.
While both conditions cause shortness of breath, there are some important differences when it comes to their symptoms, causes, and treatments.
Side-by-side comparison: COPD vs. asthma
| COPD | Asthma | |
|---|---|---|
| Symptoms |
|
|
| Causes |
|
|
| Diagnosis |
|
|
| Treatment |
|
|
| Progression |
|
|
What are the differences between COPD and asthma?
Because the symptoms of asthma and COPD are very similar, it can be hard to tell them apart. But there are some things that distinguish them.
Age
COPD is a disease that nearly always develops later in life, usually when someone is over age 40. Asthma often (but not always) begins in childhood. Some people with childhood asthma outgrow it, while others continue to have the condition as an adult.
Can you get asthma as an adult? Most people get a diagnosis of asthma during childhood, but adult-onset asthma is possible.
There’s a lot of overlap in triggers for asthma and COPD. It’s important to learn about these triggers and avoid them when you can for better lung health.
If you have COPD or asthma, you might be wondering about air purifiers. Learn about the different types and whether they help.
Causes
COPD is normally caused by damage to the lungs that has occurred over a long period of time. Cigarette smoking is the primary cause of COPD. Other exposures that can contribute include:
Secondhand smoke
Indoor air pollution from burning wood, coal, or animal manure for cooking and heating
Outdoor air pollution
Chemical fumes and dust
A rare genetic disorder called alpha-1-antitrypsin deficiency can also make your lungs susceptible to damage and result in COPD.
Read more like this
Explore these related articles, suggested for readers like you.
On the other hand, the main issue in asthma is airway inflammation. Asthma is caused by a combination of genes, factors in infancy and early childhood, and often an underlying problem with the immune system. This immune overreaction to substances in the environment is what triggers the airways to tighten and swell.
Many people who develop asthma have a genetic predisposition to it. Because of this, asthma tends to run in families, along with allergies and eczema.
Triggers
Triggers are things that make symptoms worse. When it comes to asthma and COPD, triggers are similar. They include:
Pollen, dust, mold, pets, and cockroaches
Viral respiratory infections (flu and the common cold)
Air pollution
Tobacco smoke
Cold weather
Some people with asthma can also experience worsening of their symptoms with exercise.
Symptoms
Both asthma and COPD can cause breathing problems. But people with mild or moderate asthma don’t feel symptoms every day, whereas people with COPD do have daily symptoms.
In the early stages of COPD, it’s possible to have no symptoms at all. But eventually, people with COPD get daily symptoms that are often worse in the morning:
A daily cough that produces sputum (mucus)
Trouble breathing when moving around
Wheezing or making a whistling sound while breathing
On the other hand, most people with asthma have symptoms that can come and go, typically worsen at night, and in response to certain triggers:
Dry cough
Sudden trouble breathing
Chest tightness
Wheezing
Both asthma and COPD may cause exacerbations, when symptoms suddenly flare up and are much worse than usual.
Diagnosis
The process of getting a diagnosis isn’t much different for COPD versus asthma. In both cases, a healthcare professional will use the following:
Information about your symptoms and environmental exposures
Your family medical history
A physical examination
Lung function tests, including spirometry, which measures how much air you can breathe in and out of your lungs and how fast you can do it
Imaging tests such as chest X-rays and CT scans
The main differences between the two are that:
Lung function tests can be normal in asthma if you are well, whereas they are persistently abnormal if you have COPD.
Similarly, X-rays can be normal in asthma, but they often show lung changes with COPD.
Quiz: Could I have asthma?
Progression
There’s no cure for either asthma or COPD.
That said, childhood asthma sometimes goes away. While asthma that starts in adulthood usually doesn’t. People living with asthma tend to have variability in their symptoms. This means that they may have periods with no symptoms, but they can quickly develop symptoms when exposed to a trigger. Avoiding triggers and cigarette smoke are good strategies to limit asthma symptoms.
On the other hand, COPD is a progressive disease. This means it’s likely to get worse over time, especially if the exposure to cigarette smoke, fumes, and other triggers continues. People living with COPD can do a few things to help them live longer:
Quit smoking or don’t start smoking.
Use long-term supplemental oxygen with a portable tank when oxygen levels are low.
Participate in pulmonary rehabilitation when prescribed (more on this below).
How are asthma and COPD treated?
Treatment for both asthma and COPD rely on inhaled medications. They are meant to make you feel better and reduce how often you have exacerbations. But if those aren’t enough to keep symptoms under control, then you may need to add in other medications, too.
Inhaled bronchodilators
Most people with asthma and COPD use an inhaled bronchodilator. These are medications that open up your airways and make it easier to breathe. These can be:
Short-acting (4 to 6 hours) — a “rescue inhaler” — to relieve occasional or worsening symptoms quickly
Long-acting (12 to 24 hours) — a “maintenance inhaler” — to manage daily symptoms
Combination short-acting and long-acting inhalers (for COPD)
It’s common to use both a long-acting and a short-acting inhaler with both asthma and COPD. People with only mild symptoms might not need both.
Some common examples of asthma inhalers and COPD inhalers include:
Albuterol (Ventolin, Proair, Proventil)
Levalbuterol (Xopenex)
Formoterol (Perforomist)
Salmeterol (Serevent)
Ipratropium (Atrovent)
Tiotropium (Spiriva)
Inhaled steroids or combination inhalers
With asthma, many people also take steroid inhalers to lower inflammation in their airways.
This can be:
A separate steroid inhaler, like budesonide (Pulmicort) or fluticasone (Flovent)
A combination inhaler that contains a bronchodilator and a steroid, like fluticasone/salmeterol (Advair) and budesonide/formoterol (Symbicort), or two bronchodilators and a steroid, like Trelegy Ellipta (fluticasone furoate/umeclidinium/vilanterol)
It’s less common to use an inhaled steroid if you have COPD. But with certain types of COPD, it may be needed.
Oral medications (pills)
Depending on whether you have asthma or COPD, certain oral medications (pills) may help, either in the short term or long term.
If you have a chest infection or a flare of your symptoms with either asthma or COPD, then you may also need to take:
Antibiotics
Prednisone, a steroid medication that eases lung inflammation and supports healing
Some people with allergic asthma and exercise-induced asthma may also benefit from montelukast (Singulair), an oral medication that blocks leukotrienes, natural substances that can cause inflammation
Other treatments specific to COPD
Some people with advanced COPD may also take medications called mucolytics. These loosen up the thick sputum inside your lungs and make it easier to cough it up. Examples are erdosteine, carbocysteine, and N-acetylcysteine.
As mentioned above, pulmonary rehabilitation programs are great for people with COPD, especially after a bad exacerbation. They involve exercise, education, and peer support with professional guidance.
Rarely, lung surgery may be recommended for severe cases of COPD. That could mean removing severely damaged parts of the lung or, in extreme cases, a lung transplant.
And finally, people with very severe COPD often find relief from supplemental oxygen (an oxygen tank).
Frequently asked questions
Some people have symptoms of both COPD and asthma. This is called asthma-COPD overlap syndrome (ACOS). People with ACOS tend to be younger than people with COPD and older than those with asthma. Diagnosing this condition can be hard, but one indication is that the symptoms tend to be more frequent than with COPD or asthma alone. They also tend to be more severe, leading to more emergency room or hospital visits. Treatment for ACOS is similar to that of COPD and asthma.
Asthma doesn’t automatically progress to COPD. But childhood asthma is considered a risk factor for developing COPD later in life. This means having asthma can make someone more likely to develop COPD than someone without asthma.
Life expectancy for COPD depends on how severe it is, but it really varies from person to person. So it’s difficult to predict. Life expectancy for people with asthma has improved in recent decades due to better treatment. Most people with asthma can live long lives with good management of the condition.
The bottom line
While COPD and asthma have similar symptoms, they are not the same disease. And while it’s possible to have both, it’s not usual. Asthma tends to run in families and affect people at a younger age, while COPD happens later in life and is caused by long-term damage to the lungs, often from smoking.
There’s no cure for asthma or COPD, but there are many ways to help manage the symptoms, such as avoiding triggers, smoking cessation, and medications.
Why trust our experts?
References
Akinbami, L. J., et al. (2015). Chronic obstructive pulmonary disease among adults aged 18 and over in the United States, 1998-2009. National Center for Health Statistics.
Allergy & Asthma Network. (2024). Ask the allergist: Does chronic asthma lead to COPD?
American Academy of Family Physicians. (n.d.). COPD and asthma: Differential diagnosis.
American Lung Association. (2023). Surgery for COPD.
American Lung Association. (2024). Asthma-COPD overlap syndrome (ACOS).
American Lung Association. (2024). Prevent and recover from a COPD exacerbation or flare up.
American Lung Association. (2024). Spirometry.
American Lung Association. (2025). COPD causes and risk factors
Centers for Disease Control and Prevention. (2023). Most recent national asthma data.
DeBoer, E. M., et al. (2016). Clinical potential for imaging in patients with asthma and other lung disorders. The Journal of Allergy and Clinical Immunology.
Kumbhare, S., et al. (2016). Characteristics and prevalence of asthma/chronic obstructive pulmonary disease overlap in the United States. Annals of the American Thoracic Society.
Liu, Y., et al. (2023). Trends in the prevalence of chronic obstructive pulmonary disease among adults aged ≥18 years — United States, 2011–2021. Morbidity and Mortality Weekly Report.
National Heart, Lung, and Blood Institute. (2023). Alpha-1 antitrypsin deficiency. National Institutes of Health.
O’Bryne, P., et al. (2019). Asthma progression and mortality: The role of inhaled corticosteroids. European Respiratory Journal.
Ryrsø, C. K., et al. (2018). Lower mortality after early supervised pulmonary rehabilitation following COPD-exacerbations: A systematic review and meta-analysis. BMC Pulmonary Medicine.
van Buul, A. R., et al. (2017). Association between morning symptoms and physical activity in COPD: A systematic review. European Respiratory Review.
von Mutius, E. (2018). Childhood origins of COPD. The Lancet Respiratory Medicine.
