NORTHBROOK, Ill., March 11 /PRNewswire/ -- Men who smoke may have a less sensitive cough reflex than their nonsmoking counterparts, says a study published in the March issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (

"Little research has been conducted in the field of cough, and even less research has been done on cough reflex sensitivity in relation to tobacco smoke," said study author Peter V. Dicpinigaitis, MD, FCCP, Albert Einstein College of Medicine, Department of Medicine, Bronx, New York. "Diminished cough reflex inhibits an important defense mechanism which may make smokers more prone to respiratory tract infections and other medical conditions." The study, conducted at Albert Einstein Hospital, Division of Montefiore Medical Center, measured cough reflex sensitivity in 20 healthy males, mean age 32.2, who currently smoked. Study participants underwent cough challenge testing, which included inhaling single breaths of the agent capsaicin, a standard cough inducer, at one-minute intervals until five or more coughs were induced. Test results were compared to those of a historical control group of 50 healthy, male nonsmokers who had previously undergone the identical cough challenge test. When compared, smokers needed more than four times the concentration of capsaicin than nonsmokers to induce five or more coughs. "Long-term exposure to tobacco smoke may desensitize cough receptors in the airway, increasing the tolerance to tobacco smoke and other inhaled substances," said Dr. Dicpinigaitis. "We can speculate that as individuals become less exposed to tobacco smoke, their cough receptors become less inhibited, resulting in a more sensitive cough reflex. This may be the reason why former smokers briefly develop a cough after smoking cessation." "Although difficult to prove, it also is likely that healthy smokers have a naturally blunted cough reflex," said Umesh G. Lalloo, MBChB, MD, FCCP, Nelson R. Mandela School of Medicine, Department of Medicine, South Africa, and author of a corresponding editorial. "This may explain why some individuals tolerate the acute effects of smoking and become addicted to nicotine." Subjects were selected for the study based on smoking status, defined as smoking at least five cigarettes daily for one year. Subjects had no history of asthma or chronic cough or recent symptoms of respiratory tract infection and were not receiving any medications known to affect cough reflex sensitivity. A gender-specific study was performed because past research indicates that cough reflex is significantly more sensitive in women. "This study reinforces the need for smoking cessation. In addition to a weakened cough reflex, people who use tobacco can develop more serious medical disorders such as emphysema, COPD, and lung cancer," said Udaya B. S. Prakash, MD, FCCP, President of the American College of Chest Physicians. "The most effective preventive measure for these conditions is to stop smoking or never start."

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