Last decade we are witnessing change from traditional reactive approach to new complex P4 assessment of diseases. The P4 medicine is a proposed new form of medical practice that combines Personalized, Predictive, Preventive, and Participatory elements. This new paradigm with success can be applied for management of respiratory diseases. For example: what does P4 medicine mean for COPD? It will be “personalized” because it will be based on the genome of each person; it will be “predictive” because this personalized information will be able to determine the risk for COPD in each individual; it will be “preventive” because, given the prediction of risk of COPD, prophylactic measures will be able to be taken to decrease risk also with accent on awareness in each individual case; and it will be “participative” because many of these prophylactic interventions will require the participation of the COPD patient.