Smokers Cough Symptoms and Management

A smoker’s cough is a persistent cough that develops in long-term smokers—”persistent” meaning that it’s present for more than 2 or 3 weeks.

At first it may be dry (in smokers who haven’t smoked for very long), but over time it usually produces phlegm. This phlegm can be clear, white, yellow, or even green in color.

The cough is usually worst upon awakening, and improves over the remainder of the day.


There are generally two types of cough that occur due to smoking. The first type occurs when the body coughs in reaction to inhaled toxins and lung irritants.

This type of cough is generally dry and stops shortly after the smoke has been cleared out of the lungs.

Prolonged or long-term smoking results in an ongoing, chronic smoker’s cough. A smoker’s cough is generally a wet cough that is productive of phlegm, which can be clear, white, yellow-green or blood tinged.

Yellow-green phlegm may indicate a infection of the lungs that has occurred as a complications of long-term smoking. These include acute bronchitis or pneumonia.

Symptoms that can occur in conjunction with a smoker’s cough include shortness of breath and chest pain, wheezing (a whistling sound made with breathing) and crackles (a crackling or bubbling sound made with breathing).

Unless a person who smokes stops smoking, these symptoms and the smoker’s cough tend to get progressively worse over time.

If smoker’s cough is due to or accompanies severe chronic bronchitis, additional symptoms can include a change in alertness or mental status, fatigue, weakness, confusion, anxiety, dizziness, and pallor or cyanosis (blue tinged coloring of the skin, especially around the mouth in the extremities).

Complications of chronic bronchitis can be life- threatening and include pneumonia, heart disease, respiratory failure, and hypertension.

What Causes The Cough?

The airways are lined with cilia: tiny hair-like cells that catch toxins in inhaled air and move them upwards toward the mouth.

Smoking paralyzes these cells so they’re unable to do their job. Instead of being caught in transit, toxins are allowed to enter the lungs, where they settle and create inflammation.

This, in turn, leads to coughing as the body attempts to clear these substances from your lungs. During the night, these cilia begin to repair themselves as they’re no longer exposed to the toxins in smoke.

As the cilia are called upon to catch and remove the accumulated toxins, the result is an increase in coughing upon arising in the morning.

How Common is It?

There isn’t a lot of information about the frequency of smoker’s cough.

In one study of young military recruits, 40% experienced a chronic cough with sputum production (vs 12% in non-smokers). Since the cough is more common in long-term smokers, the actual percentage is likely higher than this.

How Can You Differentiate a Smoker’s Cough From a Cough That’s Serious?

Unfortunately, the answer is that you really can’t. Sometimes the only sign that you may have lung cancer (or a serious lung condition such as COPD) is a persistent smoker’s-cough-sounding-cough.

If you have a chronic smoking-related cough, it’s important to see your doctor if it changes in any way: if it becomes more frequent or painful, for example, or if it sounds different to you.

Certain signs and symptoms can mean your cough could be due to another medical condition that should be evaluated.

Treatments for Smokers cough

A smoker’s cough can be cured in many cases by quitting smoking or smoking cessation.

The longer a person smokes, the harder it might be to quit and more likely that permanent damage may be done to the lungs resulting in such complications as lung cancer, chronic bronchitis, and other forms of chronic obstructive pulmonary disease, such as emphysema.

Smoking cessation is very difficult due to the highly addictive nature of the chemical nicotine found in cigarettes.

Smoking cessation usually takes a combination of perseverance, a multifaceted plan, and the support of the people close to the smoker.

It is not unusual for it to take several attempts before a smoker is able to permanently quit smoking.

A smoking cessation program can include nicotine replacement therapy, an ongoing support system, including supportive family and friends, and a smoking cessation support group.

It is a good idea to consult with your primary care provider before starting a smoking cessation program for recommendations for nicotine replacement therapy and support groups.

If a smoker’s cough occurs in conjunction with chronic bronchitis, treatment includes smoking cessation and medications, such as bronchodilators and corticosteroids, which are inhaled into the lungs using a device called an inhaler.

Bronchodilators help to relax and open up the lower airways in the lungs, and corticosteroids reduce airway inflammation.

Pulmonary rehabilitation is another form of treatment for chronic bronchitis. It can involve a medically supervised exercise program, disease management training, and nutritional and psychological counseling to help improve overall health and quality of life.

Severe cases of chronic bronchitis require hospitalization.

Acute bronchitis is treated with smoking cessation and supportive care, such as getting plenty of rest and fluids and using a humidifier.

Over-the-counter or prescription medications are recommended to relieve pain, fever, and cough. If acute bronchitis is caused by a bacterial infection, an antibiotic will be prescribed as well.

If there is shortness of breath, a bronchodilator may be needed. Severe cases of acute bronchitis require hospitalization.

Practices and treatments that may help your cough include:

Staying well-hydrated. Drinking 8 8-oz glasses of water per day can help thin secretions in the respiratory tract.

Gargling with salt water.

Using cough drops or lozenges that soothe your throat.

Honey. In one study, a teaspoon of honey was found to be more effective than many over-the-counter cough preparations in reducing cough symptoms. You can enjoy a little honey alone, or add it to a warm tea.

Boiling water with mint or eucalyptus leaves, then inhaling the vapors. To do this, some people place a towel over the pot of water to help inhale the vapors. Be careful to avoid burns by maintaining a safe distance from the steam, and always keep the pot on a level surface away from children.

Elevating your head when sleeping. When you lie flat, mucous can pool in your throat, making your cough worse when you awaken.

Exercise. Exercise can help to remove phlegm, in addition to its other benefits.

Eating a healthy diet. While it hasn’t been proven, some people believe that a diet high in fruits and cruciferous vegetables, such as broccoli and cauliflower, can aid the body in detoxifying some of the chemicals breathed in through tobacco smoke.

Social Impact

We tend to focus on the physical effects of symptoms in medicine, but a chronic cough can have significant emotional and social implications as well.

Imagine attending a play, or a grandchild’s piano recital, or even just a cocktail party. In addition to annoying others who are trying to enjoy themselves, your cough—if it lasts beyond the early morning—can interfere with activities you enjoy.

Of course, leisure time isn’t the only concern: Unless you work alone, your co-workers may be affected as much as, if not more than, you are by your cough. If you’ve been living with a cough a long time, you may be accustomed to the sound and disruption.

The same may not be true for your boss and colleagues.

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