The chronic obstructive pulmonary disease (COPD) is responsible for important morbidity, mortality and health costs. Projection in 2020 suggests that COPD will be the 3rd cause of world mortality (6th in 1990). Although active smoking remains the main risk factor other exposure may also be involved in the development of COPD associated with genetic predisposition. The prevalence of the COPD fluctuates according to countries, age and sex. In France, mortality due to COPD remains stable in males but increases in females. A present, COPD is approximately responsible for 15,000 deaths per year. The major challenge in the near future rests on prevention and early detection of the disease. Smoking cessation allows a deceleration of the decline of the FEV1 and an improvement of total survival.