Smoker's Cough: Causes and Warning Signs

This page is general information from public health sources. It is not a diagnosis. If you are worried about a cough, speak to a doctor, nurse practitioner or pharmacist, or call 811 in provinces where it is available.

Why smoking makes you cough

Health Canada explains the mechanism in its page on chronic obstructive pulmonary disease (COPD). Chemicals in tobacco smoke irritate the cilia, and this irritation impairs the body’s ability to clear mucus and foreign material from the lungs. A cough is how the body tries to do the job the cilia no longer do well.

HealthLinkBC adds two points. A chronic dry cough is usually caused by irritation from cigarette smoke. And a productive cough, one that brings up phlegm, in a person who smokes is often a sign of lung damage.

When it may be more than “just a smoker’s cough”

Health Canada describes COPD as causing frequent coughing and excess phlegm, with shortness of breath during everyday activities as the main symptom. Chronic bronchitis, one form of COPD, is a long-term cough that produces phlegm. A cough that has become part of your normal morning can therefore be a sign of disease, not only an irritation. The difference is hard to judge yourself, which is why health sites give thresholds.

These are the markers that official sources use. They are not identical, because they come from different services.

• Blood. HealthLinkBC lists sputum that is rust-coloured or contains bright red blood as a sign that a cough is more serious. The NHS says to ask for an urgent appointment, or contact its 111 service, if you are coughing up blood.
• Trouble breathing. HealthLinkBC’s cough guide tells people to call 9-1-1 for severe trouble breathing. The NHS gives finding it hard to breathe as an urgent sign too.
• Duration. HealthLinkBC lists a cough lasting longer than 10 days as a sign it is more serious, and its triage advice includes making an appointment to see a doctor within 1 to 2 weeks for less urgent cases. The NHS advises seeing a GP if you have had a cough for more than 3 weeks.
• Weight loss. The NHS includes losing weight for no reason as a reason to see a GP.

The NHS adds that a cough is rarely a sign of something serious like lung cancer.

Other causes

Smoking is not the only cause. HealthLinkBC’s list includes viral illness, pneumonia or bronchitis, chronic lung disease, stomach acid reflux, post-nasal drip, allergies, asthma, certain blood pressure medicines (ACE inhibitors), workplace dust or fumes and an inhaled object blocking the airway. This is one reason to get a persistent cough checked instead of assuming.

What helps

HealthLinkBC says the most effective way to treat a cough in smokers is to stop smoking. Health Canada’s COPD page says quitting is the single most effective intervention to prevent further lung damage, and that a chronic cough often improves compared with people who keep smoking.

Home measures from HealthLinkBC’s cough guide include fluids, gargling with warm salt water, moist air from a humidifier and extra pillows at night, and checking with a pharmacist before using cough medicine.

If you want to quit, the quitting timeline shows when coughing eases, and the lung screening eligibility checker is for people with a long smoking history. See also smoker’s lungs versus healthy lungs.