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Although tobacco-exposed persons with preserved spirometry are currently categorized as having pre-COPD by the COPD guidelines, the data from the current study emphasize that the definition of smoking-related lung disease needs to be broadened so new treatments can be developed. The study found that many individuals with a history of smoking have respiratory symptoms and increased risk of exacerbations that persist over several years, adds James Kiley, PhD, director of the division of lung diseases at the National Heart, Lung, and Blood Institute, part of the National Institutes of Health