We now appreciate the impact cigarette smoking has on the initiation and progression of the disease and eventual demise of our patients, but 60 years ago, the disease was poorly understood. Interestingly, Phillips and coworkers1 recruited only men who were aged 50 to 69 years, whereas today, we would broaden that cohort of patients with COPD. They conducted detailed studies of ventilator function, physical signs and symptoms, radiology, cardiology, and even bronchoscopy. Although it was a small cohort by today's standards, the attention to detail sheds much light on the mechanisms of the development of pulmonary dysfunction, which undoubtedly prompted thoughts of the repetitive nature of the acute exacerbations of chronic bronchitis, known today as AECB. The current impact of this disease is significant, both in financial and individual lifestyle terms, and the work of Phillips and colleagues established a clearer understanding of the impact of cigarettes and the interminable circuitous nature of the condition.