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Left: Annual PM2.5 map for the year 2021 (Wongnakae et al., 2023)

Factors associated with cognitive impairment in COPD patients Cognitive impairment in COPD arises from a complex interplay of multiple factors, including inflammation, hypoxemia, hypercapnia, acute exacerbations, comorbidities (obstructive sleep apnoea, cerebral microbleeds, anxiety, and depression), and smoking ( Inflammation Chronic pulmonary inflammation in COPD disrupts the balance between immune system-mediated damage and repair mechanisms ( Hypoxemia and hypercapnia Alveolar hypoventilation in COPD frequently results in hypoxemia and hypercapnia, both of which contribute to cognitive decline ( Hypercapnia, often severe in advanced COPD (as indicated by higher GOLD stages), exerts deleterious effects on the central nervous system

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Other tobacco products include waterpipe tobacco, various smokeless tobacco products, cigars, cigarillos, roll your own tobacco, pipe tobacco, Bidis and Kreteks

Liquids used in e-cigarette includes all liquids used in electronic smoking devices and tools and the like, whether or not they contain nicotine, according to the customs codes to be specified by a ministerial decree

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