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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. But what causes this cough? And how do you differentiate between a smoker’s cough and a cold, or something more serious?
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
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.
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.
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
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.
 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.
 Eldridge, Lynne MD. What are the Symptoms and Causes of a Smoker’s Cough? Verywell.com. Last updated November 7, 2017.