Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, affecting an estimated 1.2 million people in the UK. The most common cause is tobacco smoke. Patients with COPD experience a high symptom burden, worsened during periods of disease instability (termed exacerbations or ‘lung attacks’). Diagnosis requires clinical, laboratory and functional assessment to tailor treatments towards symptoms and exacerbation risk. To date, smoking cessation is the single most important intervention in delaying disease progression and should be a focus at every patient interaction.