The cough is usually triggered by the accumulation of thick sputum in the airways due to inflammation caused by smoking.
Giving up smoking usually stops the cough but it may take time.
In general, the longer a person has been smoking, the longer it will take.
Smokers with a cough should seek medical advice, particularly if their cough changes, because smoking is associated with lung cancer (see tobacco-smoking).
The explosive nature of coughing results in a spray of droplets into the surrounding air and, if these are infective, hastens the spread of colds (see COLD, COMMON) and INFLUENZA. Coughing is, however, a useful reaction, helping the body to rid itself of excess phlegm (mucus) and other irritants. The physical e?ort of persistent coughing, however, can itself increase irritation of the air passages and cause distress to the patient. Severe and protracted coughing may, rarely, fracture a rib or cause PNEUMOTHORAX. Coughs can be classi?ed as productive – when phlegm is present – and dry, when little or no mucus is produced.
Most coughs are the result of common-cold infections but a persistent cough with yellow or green sputum is indicative of infection, usually bronchitis, and sufferers should seek medical advice as medication and postural drainage (see PHYSIOTHERAPY) may be needed. PLEURISY, pneumonia and lung CANCER are all likely to cause persistent coughing, sometimes associated with chest pain, so it is clearly important for people with a persistent cough, usually accompanied by malaise or PYREXIA, to seek medical advice.
Treatment Treatment of coughs requires treatment of the underlying cause. In the case of colds, symptomatic treatment with simple remedies such as inhalation of steam is usually as e?ective as any medicines, though ANALGESICS or ANTIPYRETICS may be helpful if pain or a raised temperature are among the symptoms. Many over-the-counter preparations are available and can help people cope with the symptoms. Preparations may contain an analgesic, antipyretic, decongestant or antihistamine in varying combinations. Cough medicines are generally regarded by doctors as ine?ective unless used in doses so large they are likely to cause sedation as they act on the part of the brain that controls the cough re?ex.
Cough suppressants may contain CODEINE, DEXTROMETHORPHAN, PHOLCODINE and sedating ANTIHISTAMINE DRUGS. Expectorant preparations usually contain subemetic doses of substances such as ammonium chloride, IPECACUANHA, and SQUILL (none of which have proven worth), while demulcent preparations contain soothing, harmless agents such as syrup or glycerol.
A list of systemic cough and decongestant preparations on sale to the public, together with their key ingredients, appears in the British National Formulary.... cough
Symptoms The ?rst, or catarrhal, stage is characterised by mild, but non-speci?c, symptoms of sneezing, conjunctivitis (see under EYE, DISORDERS OF), sore throat, mild fever and cough. Lasting 10–14 days, this stage is the most infectious; unfortunately it is almost impossible to make a de?nite clinical diagnosis, although analysis of a nasal swab may con?rm a suspected case. This is followed by the second, or paroxysmal, stage with irregular bouts of coughing, often prolonged, and typically more severe at night. Each paroxysm consists of a succession of short sharp coughs, increasing in speed and duration, and ending in a deep, crowing inspiration, often with a characteristic ‘whoop’. Vomiting is common after the last paroxysm of a series. Lasting 2–4 weeks, this stage is the most dangerous, with the greatest risk of complications. These may include PNEUMONIA and partial collapse of the lungs, and ?ts may be induced by cerebral ANOXIA. Less severe complications caused by the stress of coughing include minor bleeding around the eyes, ulceration under the tongue, HERNIA and PROLAPSE of the rectum. Mortality is greatest in the ?rst year of life, particularly among neonates – infants up to four weeks old. Nearly all patients with whooping-cough recover after a few weeks, with a lasting IMMUNITY. Very severe cases may leave structural changes in the lungs, such as EMPHYSEMA, with a permanent shortness of breath or liability to ASTHMA.
Treatment Antibiotics, such as ERYTHROMYCIN or TETRACYCLINES, may be helpful if given during the catarrhal stage – largely in preventing spread to brothers and sisters – but are of no use during the paroxysmal stage. Cough suppressants are not always helpful unless given in high (and therefore potentially narcotic) doses, and skilled nursing may be required to maintain nutrition, particularly if the disease is prolonged, with frequent vomiting.... whooping-cough
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