A charity is calling for action after the number of people with an incurable lung disease rose by more than a quarter in under a decade.
There are now 139,187 patients with Chronic Obstructive Pulmonary Disease in Scotland, 26% more than in 2011.
However, more people are living longer with the condition.
Chest Heart and Stroke Scotland believes pulmonary rehabilitation is the answer, and could save NHS Scotland nearly £10m within two years.
A Scottish government spokesman said it was aiming to publish a Respiratory Care Action Plan later in the year.
'It was a shock - I found it harder and harder to keep up'
Jock Shiells, 66 from Eyemouth is living with COPD, after being diagnosed in 2004.
He lives with his wife and has four children and six grandchildren. It was a big shock to him when he was first diagnosed and it took him a long time to accept that he could no longer do the things he used to.
"It was hard to cope with being short of breath," he said. "I was finding it harder and harder to keep up with friends and family when we were out and about.
"It was five years after my initial diagnosis before I was able to take part in pulmonary rehabilitation.
"That helped me the most to understand and manage the condition. It should be something that is available to everyone who needs it."
Mr Shiells has now started a community exercise group which helps people maintain the benefits of their rehabilitation courses by keeping active.
When physiotherapy ends, his group steps in to encourage sufferers to continue exercising.
He said: "We provide classes in gym work, swimming and social interaction. I have over 100 people in total attending our classes throughout the week and they are all helped immensely both physically and mentally as a result.
"The combination of exercise and socialising is what makes this so beneficial."
On World COPD Day, Chest Heart & Stroke Scotland is arguing that thousands of Scots are missing out on vital support such as pulmonary rehabilitation - treatment usually delivered by a physiotherapist combining exercise and education.
It also warns that the NHS is missing out on significant savings as a consequence.
The charity argues that its plan for rehabilitation would save NHS Scotland almost £10m within two years.
It wants the government to commit to all patients having the right to access pulmonary rehabilitation in Scotland, in addition to improving long-term community support to help patients retain the benefits of treatment.
The condition, which includes non-reversible asthma and diseases such as emphysema and chronic bronchitis, often leaves sufferers with shortness of breath and can prove fatal.
Chest Heart & Stroke Scotland chief executive Jane-Claire Judson said: "We need to see urgent reform to help people breathe better and really live life to the full with COPD.
"More and more people are living in poor health and struggling to cope with symptoms like breathlessness. Without proper support, everything can be difficult, from returning to work and enjoying time with family and friends. Even leaving the house can be a massive challenge.
"Access to pulmonary rehab and follow-up community support is life-changing. It can prevent hospital admissions and halve the time you spend in hospital, so it also saves the NHS money."
But she said access was patchy and estimated that more than 60,000 people could be missing out on pulmonary rehabilitation.
She added: "As a result, people with COPD are more likely to be admitted to hospital - particularly in the winter months when the colder weather leaves COPD sufferers more vulnerable.
"We need to see the Scottish government's Respiratory Care Plan really commit to bold reform that makes sure everyone who needs pulmonary rehab gets it quickly and that proper follow-up support is available in the community."
A Scottish government spokesman said: "We are developing the first Respiratory Care Action Plan, which we aim to publish for public consultation later this year. The plan will set out the main priorities to support the prevention, diagnosis and treatment of respiratory conditions, including COPD.
"Access to pulmonary rehabilitation is a key recommendation in national clinical guidelines we expect NHS boards to follow, and it will form an important part of the plan."