Shortness of Breath in Smokers: Causes and When to Act

Breathlessness often shows up first during everyday activities, such as climbing a flight of stairs. This page covers what Canadian health bodies say about the link with smoking, which signs need emergency help and what quitting can change.

Why smoking can leave you short of breath

Health Canada names shortness of breath during everyday activities as the main symptom of chronic obstructive pulmonary disease (COPD). The Lung Health Foundation says smoking causes 80 to 90% of COPD cases.

The Lung Health Foundation gives examples of what this feels like: breathlessness while climbing stairs or carrying groceries. It adds that feeling short of breath is not a normal sign of aging. Other COPD symptoms it lists include a cough that lasts three months or more and unintended weight loss.

For more on the conditions themselves, see our pages on COPD symptoms, emphysema, chronic bronchitis and what smoking does to the lungs. A long-running cough is covered in smoker’s cough and when to see a doctor.

Signs that mean call 911

The Lung Health Foundation lists these signs for a COPD flare-up and says to call 911 if you have them:

• Chest pain
• Blue lips or fingers
• Confusion, trouble thinking clearly, or feeling very agitated
• Drowsiness
• Extreme shortness of breath

The same page says that if you cannot reach your healthcare provider about a flare-up, you should go to the nearest hospital emergency department, and that you should act within 48 hours rather than wait it out.

When to book a doctor visit

The Lung Health Foundation says to talk to your healthcare provider if you are short of breath during everyday activities. It also says to contact your provider if you are short of breath without flare-up symptoms. The page suggests that someone who is breathless doing simple tasks can ask about spirometry. Our page on the spirometry test explains what to expect.

Spirometry is a simple breathing test that measures how quickly and how much air you can breathe out. The Lung Health Foundation describes it as the gold standard for diagnosing COPD. A chest X-ray can show some signs and help rule out other conditions, but it cannot confirm COPD on its own.

What quitting changes

Health Canada says quitting smoking is the single most effective intervention in preventing further lung damage and slowing the progression of COPD. It also says respiratory symptoms, most notably a chronic cough, often improve once people stop.

On its timeline for quitting, Health Canada says that between 2 weeks and 3 months the airways in your lungs relax and you can breathe easier. The Lung Health Foundation says it is never too late to quit and that effective medications and programs exist. Our guide to free quit-smoking help lists what is available.

Health history questions your provider may ask, according to the Lung Health Foundation, include whether you smoke or used to, how often you feel breathless and what makes it worse, how long you have had a cough, and whether anyone in your family has had lung disease. Another test it mentions is oximetry, which uses a clip on a finger, toe or earlobe to measure blood oxygen.

What we could not confirm

• A full list of non-smoking causes of shortness of breath. The pages we read focus on COPD, so this page does not cover heart conditions, asthma or infections.
• Emergency signs outside COPD. The 911 list above is the Lung Health Foundation’s list for COPD flare-ups. We did not find a HealthLinkBC page listing emergency signs for breathlessness in general.
• How much breathing improves for any one person after quitting. Sources give general timelines only.