Ertan Yazar, EsraDemirci, NilgünArpınar Yiğitbaş, BurcuÇalıkoğlu, MukadderGülbaş, GaziTuran, Muzaffer OnurŞahin, HülyaMirici, Nihal Arzu2026-02-032026-02-0320250002-96291538-2990https://doi.org/10.1016/j.amjms.2025.07.001https://hdl.handle.net/20.500.12428/34881Purpose The finding that COPD can also develop in non-smokers has led to further investigations of etiologic causes other than smoking. This study evaluated the relationship between tobacco smoking and/or biomass-burning smoke exposure (BBS) and the demographic, clinical, and prognostic characteristics of individuals with COPD. Methods A total of 1129 stable COPD patients from the COPET study were retrospectively analyzed. The patients were divided into three groups: the COPD-B group ( n = 52), which included patients who were solely BBS; the COPD-C group ( n = 634), which included patients who exclusively tobacco smoking; and the COPD-BC group ( n = 443), which included patients with both BBS and tobacco smoking. Results The average age of the patients was 65.8 ± 9.1 years, and 87.4 % of them were men. In the COPD-B group, the following factors were significantly greater compared to the COPD-C and COPD-BC groups: age ( p = 0.001), BMI ( p = 0.001), percentage of female patients ( p < 0.001), FEV 1 /FVC ratio ( p = 0.014), eosinophil count ( p < 0.001), ADO score ( p < 0.001), and the proportion of patients with frequent exacerbations ( p = 0.013). Thorax CT scans showed that the COPD-BC group had a greater incidence of bronchiectasis and emphysema than the COPD-B and COPD-C groups ( p < 0.001). Conclusions This study highlights significant clinical and radiological differences among COPD patients based on tobacco smoking and BBS, which may substantially impact COPD outcomes, including exacerbations and prognosis.eninfo:eu-repo/semantics/closedAccessNon-smokersBiomassChronic obstructive pulmonary diseaseEtiotypesTaxonomyArticle370436537010.1016/j.amjms.2025.07.001Q2WOS:0015844778000102-s2.0-10501274338340645336Q2