The rising mortality from COPD among African Americans is of great concern. The possibility that blacks may be more susceptible than whites to the damaging effects of tobacco smoke raises important questions about the potential future impact of COPD, which may be underestimated. More research to resolve this issue and explore underlying mechanisms is needed. In addition, as compared with other respiratory diseases, there is a notable lack of data about racial disparities in treatment and outcomes among patients with COPD. Both the pharmaceutical industry and other funding agencies should make more effort to support this research and to ensure that more minorities are enrolled in clinical trials evaluating new COPD therapies in the future. © 2006 Elsevier Inc. All rights reserved.