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Mr Humphrey is a 64 year old ex-smoker. He presents with a 2 year history of cough and worsening dyspnoea when walking up a gradient. He is referred for a chest X-ray which demonstrates hyperinflation. Subsequent spirometry demonstrates a post-bronchodilator FEV1/FVC of 0.56.

Based on the likely diagnosis, what is the most appropriate initial management option?

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