What Is Smoker's Cough?

Smoker's cough is a persistent cough that results from damage to the airways caused by toxins in cigarette smoke. If you smoke and have a cough that lasts more than 3 weeks, you may have smoker's cough. Over time, smoker's cough can lead to hoarseness and chest pain. It can also be among the signs and symptoms of lung cancer.

One study of young military recruits found that 40% of the 525 subjects who smoked regularly experienced a chronic cough with sputum production; only 12% of the 408 non-smoking participants did. Since a smoker's cough is more common in long-term smokers, the percentage is likely much higher in older populations or those with a greater smoking history.

Smoker's Cough Symptoms

As with any type of cough, a smoker’s cough is essentially a forceful pushing out of air to clear an irritant from the airways (the bronchi and bronchioles).

However, there are certain characteristics that can make smoker's cough unique. A smoker's cough may:

• Be persistent and nagging, lasting more than two or three weeks
• Cause a wheezing or crackling sound
• Be wet and productive, meaning phlegm or sputum (a mucousy substance) is present. Note, however, that the cough may be dry in the early stages of smoker's cough or in people who haven't been smoking long.
• Be worse upon awakening, with a tendency to lessen over the course of the day

Complications

There are few complications associated with smoker's cough itself. That said, repeated hard coughing can strain chest muscles and even lead to broken ribs.

Women with a persistent smoker's cough may leak urine due to pressure put on the bladder from coughing.

Causes

Cilia are tiny hair-like cells that line the airways. They catch toxins in inhaled air and move them toward the mouth to prevent them from reaching the lungs.

Certain chemicals in tobacco smoke, such as formaldehyde, paralyze these delicate structures and make them unable to capture toxins. As a result, the toxins are able to enter the lungs, where they settle and spur inflammation.

Because they are not being exposed to smoke while you sleep, cilia can begin to repair themselves (however briefly and to a limited extent). The work they do to catch and remove accumulated toxins at night means increased coughing to clear it all out once you wake.

Diagnosis

A smoker's cough can be identified based on symptoms and a history of smoking. However, it's virtually impossible to differentiate a smoker's cough from a lung cancer cough with this information alone.

Certain signs and symptoms may prompt your healthcare provider to consider the possibility of lung cancer and explore testing that can help make (or rule out) this diagnosis. That said, sometimes a cough is the only symptom of the disease.

Hemotypsis (coughing up blood) is the strongest predictor of lung cancer, although only a fifth of people with this disease have this symptom.

Even a little blood is reason for an immediate evaluation. Coughing up a teaspoon or two of blood is considered a medical emergency because it can be breathed into your lungs.

Other symptoms that can indicate lung cancer include:

• Hoarseness that lasts more than a few days or isn’t accompanied by other typical cold symptoms
• Wheezing
• Shortness of breath, which often manifests as trouble catching your breath with activity
• Unexplained weight loss
• Pain with breathing that can suggest damage to the lining of lungs (the pleura)
• Pain in the upper body, specifically the lungs, shoulders, between the shoulder blades, or back

If you smoke/have smoked and have a chronic cough, it’s important to see your healthcare provider to be evaluated. Thereafter, bring any changes in your cough to their attention (e.g., it becomes more frequent, is uncomfortable, or starts to sound different).

Treatment

The best treatment for smoker's cough is to quit smoking altogether. As you work toward that goal, you can use lifestyle strategies and, if necessary, medications to help improve your cough.

Quitting Smoking

There are many ways to quit smoking. If you're struggling to quit, have a talk with your healthcare provider about support options, such as smoking cessation aids. These include nicotine replacement therapy and medications like Chantix (varenicline) or Zyban (buproprion).

Some who quit are alarmed that their smoker's cough increases immediately afterward. Known as smoking cessation cough, this is actually normal.

After quitting, cilia are given more opportunity than they ever had while you were smoking to repair themselves. Their increasing ability to remove foreign material from the throat, trachea, and airways means more coughing to remove it.

This worsening of smoker's cough after quitting is temporary. Most can look forward to it beginning to diminish within three months of kicking the habit.

Easing Your Cough

The following strategies may help calm your cough and make it easier to cope with:

• Stay well-hydrated: Drinking eight 8-ounce glasses of water per day can help thin secretions in the respiratory tract.
• Gargle: Warm salt water is best.
• Suck on cough drops or lozenges to soothe your throat.
• Drink tea: In one study, just half a teaspoon of honey was found to be more effective in reducing cough symptoms than many over-the-counter cough preparations.
• Inhale mint or eucalyptus: One way to do this is to place fresh leaves of either herb into a bowl and pour boiling water them. Drape a towel over your head to contain the vapors and lean over the bowl just close enough to breathe them in.
• Elevate your head during sleep: This will prevent mucus from pooling in your throat.
• Exercise: Physical activity can allow you to breath more deeply and quickly, which helps loosen phlegm.
• Eat a healthy diet: Although unproven, some researchers believe including lots of fruits and cruciferous vegetables—such as broccoli and cauliflower—can help the body to detoxify some of the chemicals in inhaled tobacco smoke, which may help improve chronic respiratory symptoms and reduce lung cancer risk.

Talk to your healthcare provider before you use any cough suppressants. These medications are generally reserved for short-term use if your cough is causing significant discomfort or affecting your sleep.

Coughing has a function beyond clearing out whatever cigarettes or cigars have introduced to your airways. It also removes other materials in the environment that can get breathed in, such as household mold, exhaust from a wood stove or fireplace, or exposure to chemicals in the workplace.

Easing, rather than suppressing the cough reflex entirely, is recommended for this reason.

Frequently Asked Questions

Can lungs be repaired after quitting smoking?

Yes. Lungs are self-repairing, and smoking cessation immediately begins the process. In addition to diminished smoker's cough, lung function can dramatically improve in only a few months. After one year, the risk of heart attack and stroke drop by half, and that risk continues to drop each year thereafter.

However, it is important to know that even if smoking is stopped, the risk of lung cancer can persist and remains higher than that of a non-smoker for a lifetime. This is particularly the case in former heavy smokers.

If what appears to be smoker's cough turns out to be lung cancer, what are the survival rates?

The five-year relative survival rates for lung cancer depend on how far it spreads. Localized lung cancer that has not spread outside the lungs has a five-year survival rate of 63%. Lung cancer with regional spread, meaning it has spread to nearby lymph nodes or structures, has a five-year survival rate of 35%. Lung cancer with distant metastasis, or cancer that spread to distant parts of the body like the brain or liver, has a 7% five-year survival rate.

A Word From Verywell

If you're a smoker and you have a cough that persists—even if you believe it’s just a nagging smoker's cough—talk to your healthcare provider. A persistent cough is one of the most common symptoms of lung cancer.

That said, certain people who smoke are advised to have a yearly low-dose computerized tomography (CT) scan of the lungs regardless of whether or not they have a chronic cough. This is the best way to detect lung cancer in the earliest possible stage, when it is most treatable.

Screening is recommended for those who:

• Are between ages 50 and 80
• Have a 20 pack-year or more history of smoking
• Doesn't have a health problem that limits life expectancy or the ability to undergo treatment if a cancer is found

In addition, some guidelines recommend screening only if a person is still smoking or has quit in the past 15 years, while others have no time limit. Talk with your healthcare provider about whether screening is the right choice for you.