About COPD
COPD, or chronic obstructive pulmonary disease, is a long-term condition that affects the lungs and makes it harder to breathe. It can cause coughing, mucus (phlegm) production, wheezing and shortness of
breath.1
An estimated 300,000 New Zealanders are living with COPD – although many may not realise it. It’s most common in adults aged over 40 and it is the fourth leading cause of death in the country.2
Often, COPD is caused by inhaling pollutants, such as tobacco smoke or second-hand smoke. Other causes can include fumes, chemicals or dust in certain workplaces, as well as genetic factors.3
How COPD affects your lungs
COPD isn’t just one disease - it’s a group of conditions that cause long-term damage to your lungs
and airways.
The two main types are emphysema and chronic bronchitis.2
Chronic bronchitis2, 3
Chronic bronchitis affects the airways in your lungs. They become inflamed and narrowed, making it harder to breathe. It often leads to mucus or phlegm production and a persistent cough.
Healthy
Airways
Airways with persistent bronchitis
Inflammation and excess phlegm
Emphysema2,3
In emphysema, the walls between many of the air sacs in the lungs (called alveoli) are damaged.
This makes them lose their shape and stretchiness, making it harder to fill and empty the lungs. As a result, breathing becomes more difficult.
Healthy
air sacs
Air sacs with emphysema
Air sacs with emphysema
If you’ve been living with COPD, no doubt you will be familiar with many of the symptoms, such as:3
Increased shortness of breath/breathlessness
Frequent coughing (with or without mucus)
Wheezing
Tightness in the chest
Tired or fatigue
COPD is a life-long condition, and while you may be used to managing these symptoms, it can progress, or worsen, over time. This progression often happens slowly, so you may not notice it getting worse.3
One of the things to look out for is if you're having more ‘flare-ups’ or your symptoms are more severe or harder to
control.3
The good news is that there are treatments, such as BREZTRI, that may help you get better control of your symptoms.
If your symptoms change or worsen, contact your doctor early. Managing flare-ups early can help protect your lungs
from further damage.
When did you last check in on your COPD symptoms?
This short check-in can help you recognise changes in your symptoms or flare-ups and decide
whether it may be helpful to talk to your GP about your management plan.
What is a Flare-Up?
A flare-up, (also known simply as ‘flares’ or an ‘exacerbation’), is a sudden, often severe, worsening of COPD symptoms, such as coughing or breathlessness. Flare-ups can last for days or even weeks, and may require extra treatment, or even hospitalisation.3
Often, flares are ignored or dismissed as ‘just part of having COPD’. It is important NOT to ignore them, they could be a sign that your COPD is progressing, and repeated flare-ups can cause permanent damage to your lungs and heart.3
Recognise the Warning Signs of a Flare-Up
A COPD flare-up involves more than your usual day-to-day symptoms. Watch for changes such as:3
Increased shortness of breath or difficulty breathing
More frequent or severe coughing
Changes in mucus (colour, thickness, or amount)
Wheezing or chest tightness
Feeling unusually tired or weak
Having trouble sleeping
Fever or signs of infection
If you think you might be having flare-ups, or if your usual symptoms seem worse than before, it’s important to talk to your doctor about them as soon as possible.
Flare-ups are often caused by lung infections such as a cold, flu or pneumonia.4
Other triggers can include:
Cigarette
smoke
Dust and chemicals
in the air
Extreme temperatures,
humidity, or weather changes
How severe can flare-ups be?
Not all flare-ups are the same. Flare ups can last 2 days or more and vary with each person.5
TIP:
If your symptoms change or worsen, contact your doctor early. Managing flare-ups early can help protect your lungs from further damage.
Understanding the stages of COPD
A COPD diagnosis and breathing tests by your doctor can help identify how far your COPD has progressed and what grade or stage you are in.3
COPD can be classified into 1 of 4 grades based on your ability to breathe. The higher the grade, the more advanced the COPD.6,7
One of the main measurements used is FEV1 - which stands for forced expiratory volume in one second. This measures
how much air you can exhale from your lungs in one second.3
Knowing your grade or COPD stage helps your doctor tailor your treatment plan and track your progress over time.
Understanding the Stages of COPD6,7
Mild
Few symptoms
Breathless on moderate exertion
Little or no impact on daily activities
Cough & sputum
(mucus) may be present.
Moderate
Breathless walking on level ground
Increasing limitation of daily activities
Recurrent chest infections
May require oral corticosteroids and/or antibiotics for flare-ups
Severe
Breathless on minimal exertion
Daily activities severely restricted
Frequent flare-ups with increasing severity
Very Severe
Breathing is very difficult
Symptoms are
considered serious
Everyday activities are extremely difficult
Adapted from Asthma + Respiratory Foundation NZ. NZ COPD Guidelines 2025 and Understanding COPD Stages, American Lung Association 2025.
USEFUL LINKS:
Do not take BREZTRI AEROSPHERE® if you are allergic to any of its ingredients.
BREZTRI AEROSPHERE® is funded for COPD patients only – restrictions apply. Normal doctor’s charges and pharmacy fees apply.
For full consumer information please refer to the manufacturer’s Consumer Medicine Information available at www.medsafe.govt.nz
BREZTRI AEROSPHERE® is a registered trademark of the AstraZeneca group of companies. Registered user AstraZeneca Limited, PO Box 87453, Meadowbank, Auckland 1742. For Medical Information enquiries or to report an adverse event or product quality complaint: Telephone 0800 684 432 or (09) 306 5650 or via https://contactazmedical.astrazeneca.com TAPS MR12794 NZ-2988, Date prepared: February 2026.