3.Main findings and recommendations

3.1.1 The prevalence of COPD increased，and the airflow limitation of patients were severe.

The prevalence of COPD among residents aged 40 years or older in China was 13.6%，which was significantly higher than that of a decade ago.

43.6% of patients with COPD had moderate，severe and extremely severe airflow limitation，and early detection and control of patients with COPD were weak.

3.1.2 COPD Risk factors prevailed

The smoking rate of residents aged 40 years or older in China was 40.0%，and the current smoking rate was 31.0%.74.1% of males were former smokers and 57.6% of males were current smokers.The residents were severely exposed to tobacco smoke.

Nearly half of residents aged 40 years or older had been exposed to occupational dust and/or chemical gas for more than one year，and about one-quarter of them used protective equipment.

Nearly half of residents aged 40 years or older still used polluting fuel for cooking，and more than one-third of households used polluting fuel for heating.The problem of indoor air pollution caused by household polluting fuel combustion still needs attention.

3.1.3 The general public had insufficient knowledge of COPD，and the rate of pulmonary function tests in the population was extremely low.

Only 9.2% of residents aged 40 years or older knew the term of COPD and less than 1% of patients were aware of their diagnosis of COPD.The public’s awareness of COPD needs to be improved.

The pulmonary function test rate of residents aged 40 years or older was less than 5%.The pulmonary function test rate of patients with COPD was less than 6%.The abilities of pulmonary function test and COPD diagnosis were obviously insufficient.Most patients with COPD were not treated.

3.2.1 Integrate the concept of prevention and treatment of COPD into relevant policies，build a comprehensive prevention and control system for chronic respiratory diseases mainly on COPD，and promote the formulation and implementation of relevant health control policies.

3.2.2 Continue to carry out surveillance of COPD and expand the scope of surveillance，guaranteeing the surveillance information with national and provincial representativeness.Improve the comprehensive surveillance system of COPD，and gradually implement surveillance of COPD prevalence，COPD incidence and patients’ follow-up.Strengthen deep and comprehensive analysis and application of surveillance information，carry out surveillance related research，and provide scientific basis for formulating policies and strategies for prevention and treatment of COPD.

3.2.3 Through a variety of ways，which is，through national projects（such as COPD comprehensive surveillance program，COPD screening program among high-risk population，etc.），improve the ability of COPD diagnosis and treatment among primary care physicians，and develop the mechanism of pulmonary function test in high risk population on their first visit in primary medical institutions.Carry out COPD screening in high risk population and occupational group，and continuously increase the rate of pulmonary function tests through the strategies and measures such as including pulmonary function tests in routine physical examinations of those over 40 years old.

3.2.4 Carry out comprehensive interventions for COPD and integrate the management of COPD patients into basic public health services.

3.2.5 Strengthen the capacities of prevention and control of COPD in primary health care institutions，increase the number of professionals at all levels of disease control institutions and the relevant facilities of primary health care institutions，and clarify the responsibilities of medical institutions in the field of comprehensive prevention and control of COPD.Improve the ability of the health care system to respond to the prevention and treatment of COPD.

3.2.6 Extensively carry out health education and health promotion activities，enhance the awareness and attention of the whole society on COPD，and improve the health literacy of the whole people in the prevention and treatment of COPD.

3.2.7 Strengthen inter-departmental cooperation，create a social support environment for the prevention and treatment of COPD，and control the prevalence of risk factors associated with COPD.