The Nippon COPD Epidemiology (NICE) study showed an estimated prevalence of 5.3 million Japanese people over the age of 40 afflicted with COPD. Recent studies estimated that it will become the largest cause of death. Nevertheless, COPD is estimated not to be currently widely recognized as one of the three major lifestyle diseases affecting Japan. Therefore we investigated the need to spread the awareness of COPD and its threat. Subjects were over the age of 18. A questionnaire of a free participatory research method (self-selection and writing) was examined in 335 cases. The answer of ''COPD is known'' was only a few 9.3% of participants. The results of unknown reasons (multiple answers allowed) ''Less related to yourself'' were 16.6%, of ''Difficult to recognize the concept of disease'' were 62.1%, and of ''Non-Japanese name'' were 44.8%. The question about ''Easy to learn and understand the disease by its Japanese name?'', 'Tobacco disease (TABAKO BYOU)' had the most answers. Many answers were given to 'Chronic tobacco lung (MANSEI TABAKO HAI)' and 'Lifestyle disease of the lung (HAI SEIKATSU SHUKAN BYOU)'. ''What do you think the way for more recognized COPD?'' received many answers in TV commercials, Newspapers, and/or Magazines. Following the answers were Public lectures about the disease and Increase of tobacco tax. Lung age (HAINENREI) was also rated low in awareness. These results suggest that for better understanding, a more familiar combination (of terms) in a simplified native name may be useful. Furthermore, our aggressive educational activities (including regional specificity, such as urban and/or rural) are important for improving awareness of COPD.