Effect of the Inhaled Triple Therapies Over the Small Airway in Biomass Exposure

This study looks at how inhaled combination inhalers (triple therapy) affect the small airways in people with lung disease caused by breathing in smoke from burning wood or other biomass fuels — common in some communities that cook or heat with open fires. **You may be eligible if...** - You have COPD or chronic bronchitis caused by significant biomass smoke exposure (e.g., cooking fires) - You are able to use an inhaler correctly, or have a caregiver who can help - You are able to attend all study visits - You understand the instructions and are willing to give consent **You may NOT be eligible if...** - You are unable to attend study visits - You cannot use or be taught to use inhalers properly - You do not meet the medical criteria for COPD or chronic bronchitis from biomass exposure Talk to your doctor to see if this trial is right for you.