Q. Can smoking cause chest congestion and productive cough?

Answered by
Dr. Noushin Payravi
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Feb 06, 2020 and last reviewed on: Feb 08, 2020

Hello doctor,

I have chest congestion with heaviness in chest. I also have a constant cough with sputum. I am not taking any medication at present for this. Could this be due to smoking?

Dr. Noushin Payravi

Family Physician General Practitioner


Welcome to icliniq.com.

Your cough and chest congestion is probably due to bronchitis (smoking can be the underlying reason however, at the moment you are experiencing a phase of exacerbation due to infection or an allergic reaction). I would like to know about the onset of your symptoms and how long you have been experiencing these productive coughs and chest pain?

Nonetheless, CXR (chest x-ray) is the necessary step before prescribing appropriate medications. Your probable diagnosis is bronchitis (likely an allergic one). I recommend using a nasal corticosteroid to subside the symptoms such as Mometazone or Beclomethasone. You will also benefit from using antibiotics such as Azithromycin. Macrolides such as Azithromycin are not only anti-microbial agents but have some anti-inflammatory effects that are quite impressive in bronchitis.

Gargling warm saline along with installing a humidifier in your room will be of great importance. Also, a PPD (purified protein derivative) test is always recommended as a primary tool to screen tuberculosis in patients with chronic cough. Do not freak out about it but it is worth the visit since prevention is always far better than treating a late-stage infectious disease.

The Probable causes:

Allergy, infection.

Investigations to be done:

PPD, Sputum test, CXR.

Differential diagnosis:

Infectious bronchitis. Allergic bronchitis. COPD. Tuberculosis. Pneumonia.

Probable diagnosis:


Treatment plan:

Beclomethasone nasal spray, Azithromycin 1 g on the first day then 500 mg for five days, Theophylline-G suspension, one table spoon every night.

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