Is a smoker's cough dangerous?

No trifles

The smoker's cough is a sign that the self-cleaning machinery of the respiratory tract is overloaded. If the cough persists for a long time, it can be assumed that the toxins in cigarette smoke have already caused damage and thwarted mucociliary clearance.

Normally, millions of cilia on the bronchial mucous membrane ensure that foreign particles or pollutants that have penetrated are transported back outside. A mucus film produced by the goblet cells serves as a conveyor belt that is moved by the synchronously beating cilia in the direction of the pharynx outlet. There the mucus mixes with the saliva and is swallowed unnoticed.

The aggressive ingredients of cigarette smoke lead to considerable disturbances in the function of the cilia, and later structural damage to the cilia occurs. Heavy smokers expose themselves to the risk that at some point only stumps of the cilia are left. The ciliated epithelium looks like it has been eaten away when looking through the electron microscope. The destructive process is gradual, and in the beginning only the smoker's cough indicates that something is wrong. The brown mucus that is brought to light is evidence of the increasing contamination of the bronchial system.

The goblet cells reactively produce large amounts of secretion that has to be removed and coughed up. The cleaning machinery runs at full speed, especially at night, when the bronchi can enjoy longer, smoke-free breaks. That is why the coughing attacks are particularly violent and productive in the morning after getting up, whereby the thick consistency of the mucus makes it difficult to cough up.

The accumulating pollutants lead to inflammatory reactions in the bronchial mucous membrane, which, in addition to the excessive production of mucus (hypercriny), are responsible for the smoker's cough. With continued cigarette consumption, it must be expected that chronic bronchitis will develop at some point. According to the World Health Organization (WHO), cough and sputum occur most days of the year, but for at least three months in two consecutive years.

Easy game for pathogens

In chronic bronchitis, viruses and bacteria have an easy job. On the one hand, the increased mucus offers an ideal environment for colonization; on the other hand, the mucosal barrier does not function optimally. In the winter months things can happen in quick succession: no sooner has a respiratory infection been overcome than the next one is already on the horizon.