COPD is a major cause of chronic morbidity and mortality worldwide. The WHO (World Health Organization) World Health Report 2004 lists COPD as the fifth leading cause of mortality in WHO regions, and further increases in prevalence and mortality are expected in the coming decades (9,10). A large US survey on COPD reported that during 2000, an estimated 10 million adults in the US reported physician-diagnosed COPD, but 24 million adults had evidence of airflow limitation, again indicating that COPD is largely under diagnosed (11). COPD accounts for many visits to health-care workers. In the UK, general practice consultations for COPD in one year ranges from 4.17 per 1,000 people aged 45–64 years, to 8.86 per 1,000 people aged 65–74 years old, and a high of 10.32 per 1,000 people aged 75–84 years old (12).