Smoker’s Cough or Cold? 6 Signs Smoker’s Cough Could Be More Serious

We’ve all heard it. The incessant hacking of a smoker’s cough. While not all smokers develop this symptom, a study conducted on military personnel ages 18-21 found that 41% of daily smokers and 27% of occasional smokers reported a high frequency of chronic cough and mucus production.^[1] But what causes this cough? And how do you differentiate between a smoker’s cough and a cold, or something more serious?

What is a Smoker’s Cough?

While it may be self-explanatory, a smoker’s cough is a persistent cough that develops in long-time smokers. The cough may be dry, or it may produce sputum (phlegm, mucus), depending upon how long a person has smoked. The color of the mucus may range from clear to yellow to green to brown. The cough may be worse in the morning and improve as the day progresses. Should a smoker’s cough be taken seriously? You bet it should.²

Distinguishing between a Smoker’s Cough and a Cold

It’s fairly easy to distinguish between a cough caused by a cold and a smoker’s cough. What’s more difficult is distinguishing between a smoker’s cough and something more serious like lung cancer. A cough from a cold clears up in a week or two and is usually accompanied by a myriad of other cold symptoms such as nasal stuffiness, runny nose, low-grade fever and sore throat. A smoker’s cough is ongoing and doesn’t go away with time. It’s also not associated with other cold symptoms. While a cough caused by a cold originates in the throat and upper airways, a cough caused by smoking originates in the lungs and lower airways.

What Causes a Smoker’s Cough?

The air passages in your lungs are lined with tiny, hair-like structures called cilia. Cilia have a job to do and that is to capture toxins and impurities in inhaled air and move them rhythmically up the air passages towards the mouth where they can be expelled. The chemicals in cigarettes, including formaldehyde, paralyze the cilia so they’re unable to do their job. Instead of being captured and removed, the toxins settle in the lungs creating irritation and inflammation. This leads to the infamous smoker’s cough, as the body tries to rid the lungs of toxins by coughing. At night, when smokers are sleeping and not smoking, the cilia try to repair themselves. When the smoker awakens, the cilia once again try to remove the toxins accumulated during the night. The result is a worsening cough upon awakening.^[2]

6 Signs Your Smoker’s Cough could be More Serious

The most common symptom of lung cancer is a persistent, ongoing cough. Other warning signs that your cough may be associated with something more serious include:²

1. Hemoptysis – coughing up blood, sometimes the first symptom of lung cancer. Even if it’s only a teaspoon or two, it’s a medical emergency and you should seek medical attention right away.
2. Hoarseness – if hoarseness lasts longer than a few days and is not accompanied by other cold symptoms, you should make an appointment with your primary care provider. Although hoarseness of the voice can be due to a number of different factors, it’s better to be safe than sorry and see your doctor as soon as possible.
3. Wheezing – defined as a high pitched whistling sound made while breathing. Wheezing is strongly associated with asthma, but may also be associated with something more serious. If you start to notice you’re wheezing, be sure to get it checked out.
4. Shortness of breath with activity – often dismissed as being associated with being overweight, out of shape or getting older, if it’s getting increasingly difficult to climb a flight of stairs without getting breathless, it’s best to see your doctor.
5. Unexplained weight loss – although most people welcome weight loss with open arms, if you’re not trying to lose weight, it may be a symptom of something more serious. Call your doctor if this applies to you.
6. Pleurisy (pain with breathing) – or pleuritic chest pain may be associated with inflammation in the lining of your lungs. Because smoking alone doesn’t cause this, it’s best to seek medical advice if this applies to you.
7. Pain in your lungs (chest pain), shoulders or back – sometimes, pain in any of these areas may be related to lung cancer. Make an appointment with your doctor if this sounds like you.

If you have a cough that lasts longer than a week or two, whether you smoke or not, it’s best to make an appointment with your doctor to be thoroughly evaluated.

_{[1] Hamari A, et., al. High frequency of chronic cough and sputum production with lowered exercise capacity in young smokers. Ann Med. 2010 Oct;42(7):512-20. doi: 10.3109/07853890.2010.505933.}

_{[2] Eldridge, Lynne MD. What are the Symptoms and Causes of a Smoker’s Cough? Verywell.com. Last updated November 7, 2017.}