Smoker’s Cough: What is Happening Inside Your Lungs

Smoker’s cough stems from the effects of long-term smoking and can lead to many respiratory complications including COPD, or smoker’s lung. It can also lead to a risk of recurring lung infections, collapsed lung, or lung cancer.

Young man smoking a cigarette and coughing

One of the most recognizable traits of a long-term smoker is the smoker’s cough. Among the numerous adverse health risks smokers regularly expose themselves to, chronic bronchitis and emphysema are some of the more obvious and noticeable symptoms resulting from the lung’s continuous exposure to cigarette smoke. The combination of the two results in Chronic Obstructive Pulmonary Disease, or better known as COPD. This is also known as “Smoker’s Lung”.

Chronic Bronchitis

Chronic Bronchitis – Generally, the first stage of smoker’s cough begins with chronic bronchitis. Unlike acute bronchitis, which sometimes accompanies a cold and clears up within a week or two, chronic bronchitis is defined as lasting most days of the month for at least three months out of the year for a minimum of two consecutive years. However, as smoking is a daily habit, chronic bronchitis resulting from habitual smoking can often be a daily occurrence. Mornings are frequently the time of day where it becomes the most prevalent due to the accumulation of mucus while sleeping occurs. The loss of lung function at this point due to chronic bronchitis is considered to be irreversible.

According to the American Lung Association, “After a long period of irritation”, symptoms include:

  •  Excess mucus is produced constantly
  • The lining of the airways becomes thickened
  • An irritating cough develops
  • Air flow may be hampered
  • The lungs become scarred

According to an article on Every Day Health, a medically reviewed featured report states that “More than 90 percent of the 7.6 million Americans with chronic bronchitis have been cigarette smokers.”

Cigarette smoke is filled with chemicals and irritants that damage the lining of a person’s airways, or bronchial tubes, and lead to a buildup of mucus. The membranes that line your bronchial tubes are made up of glands that produce mucus to protect the airways, and tiny, fingerlike projections called cilia move the mucus through the tubes. Just as your nose and eyes will water from the irritation produced by a hot pepper, your body will try to protect your lungs from the irritation of cigarette smoke by producing more mucus. – Dr. Simoff


Emphysema – According to McGraw Hill Higher Education, as the production of mucus increases the lining of the bronchioles thickens. This creates difficulty breathing. The bronchioles then lose their elasticity. They are then no longer have the ability to absorb the pressure within the alveoli, which are microscopic air sacs. This then leads to a rupturing of the delicate alveolar walls. This condition is the primary signature of smoking-induced emphysema. The burst alveoli creates a sustained worsening of the cough, chronic fatigue, persistent wheezing, and difficulty breathing. “Emphysema is fifteen times more common among individuals who smoke a pack of cigarettes a day than among nonsmokers.”

According to Medical News Today, the primary symptom of smoker’s emphysema is shortness of breath. This shortness of breath may initially present itself during strenuous activities. However, as the debility progresses, shortness of breath may be present even when inactive, or sleeping. In addition, complications from emphysema may range from;

  • Pneumothorax, also called collapsed lung. This can be fatal in patients with severe emphysema because the lungs have become so weak.
  • Cor pulmonale – a part of the heart expands and becomes weak. This happens when pressure in the arteries that connect the lungs and heart increases.
  • Giant bullae – empty spaces, called bullae develop in the lungs. Giant bullae are very large, sometimes half the size of the lung. Not only does the lung have a much smaller surface area, the bullae can become infected. Patients with giant bullae are more likely to develop pneumothorax.
  • Recurring infections – chest infections, pneumonia, influenza, cold and the common cold are like to occur more often in patients with emphysema.
  • Pulmonary hypertension – abnormally high blood pressure in the arteries of the lungs.

The resulting treatment may call for the prolonged or permanent use of; Bronchodilators, Steroid aerosol sprays, Antibiotics, Rehabilitation, Oxygen tank, and may further result in the need for surgery, or a lung transplant.

Understanding COPD

COPD – The American Lung Association classifies Chronic Obstructive Pulmonary Disease as a combination of chronic bronchitis and emphysema. Symptoms include;

  • Chronic cough
  • Shortness of breath while doing everyday activities, also referred to as dyspnea
  • Frequent respiratory infections
  • Blueness of the lips or fingernail beds, which is also referred to as cyanosis
  • Fatigue
  • Producing a lot of mucus, also referred to as phlegm or sputum
  • Wheezing

In addition to the structural changes of the progression to emphysema, cellular changes may also be present – which lead to lung cancer. The cells in the outer border of the bronchial lining start to divide faster than ever before. In time, these quickly dividing cells displace ciliated cells. The nuclei starts to look like cancerous cells. They are oversized and anamorphic. They also hold an abnormal number of chromosomes. At this point, the damage may be altogether averted or repaired if smoking ceases immediately. However, if smoking cigarettes continues, these abnormal cells could in time burst through the basement membrane, dividing inside the lung tissue. This forms a tumor that holds the probability of spreading throughout the lung tissue.

Cigarette smoking is the cause of 80% of all of lung cancer cases. A five-year life expectancy is only common in about 13% of lung cancer patients.


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