As a lung specialist I am always trying to get my patients to stop smoking.  I also have many patients who have stopped smoking but complain of cough with more mucous production weeks after they have stopped smoking.  Many times the patients will make a special appointment with the office to discuss this problem since they do not know if this is normal or not. 

I probably have not had a really good answer to their questions, but now I think I do.Researchers studying the effects of nicotine on the cough mechanism of the body have come up with an interesting observation.  Oddly enough they used e-cigarettes in their study.  Patients were asked to smoke an e-cigarette that contained a nicotine cartridge.  The cough response was then measured.  Here is what was found.

Nicotine appears to have two effects on the cough mechanism.  First, there is a cough irritating effect, which is noted initially.  The patients cough when they first experienced the nicotine containing smoke from an e-cigarette.  Second, the nicotine was found to suppress the more complex cough reflex that we all have and which protects our lower airway from things we might aspirate.  This suppression of the cough reflex can last as long as two weeks after exposure to inhaler nicotine.  This is more than an interesting finding. It is the answer to many of my patient’s concerns about increased cough weeks after smoking cessation, but if you are still concerned do not hesitate to come and see me.