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Smoking
May Dull Cough Reflex in Some
Excerpt
By Jacqueline
Stenson,
Reuters Health
Smoking may impair a person's cough
reflex, potentially raising the risk of respiratory infections,
suggests a study of young male smokers with no signs of lung disease.
"This study uncovers another negative
potential effect of smoking," said study author Dr. Peter V. Dicpinigaitis,
director of the intensive care unit at Albert Einstein Hospital
in New York City.
"Cough is a very important protective
reflex," Dicpinigaitis told Reuters Health. "If cigarette smoking
blunts cough, it may render smokers susceptible to respiratory
infections."
He explained that coughing acts
as a "cleaning mechanism" that keeps foreign material from entering
the respiratory tract and clears mucus from the airways. And if
the airways are not cleared, it's possible that bacteria may linger,
leading to infections, he said.
The results appear to run contrary
to the fact that many people who smoke for years develop a "smoker's
cough."
But this cough can result from
conditions such as chronic bronchitis, which causes excess mucus
in the respiratory tract and tightened airways that prompt coughing.
None of the study participants had bronchitis, asthma or other
lung diseases.
Though it's not clear how smoking
could dull the cough reflex, Dicpinigaitis said he believes the
most likely explanation is that it desensitizes cough receptors,
making a person more tolerant of tobacco smoke.
But it may also be possible, Dicpinigaitis
said, that people who become regular smokers are those who are
less likely to cough to begin with and therefore more likely to
stick with the habit than people who inherently cough more readily.
His study, published in the March
issue of the journal Chest, involved 20 young men who had smoked
for an average of nearly 11 years.
Participants underwent cough sensitivity
tests in which they inhaled various levels of capsaicin, a cough-inducing
chemical that puts the "hot" in hot peppers and is frequently
used in cough research.
Their test results were compared
with those of a previous study by Dicpinigaitis in which 50 similarly
aged, healthy, non-smoking men underwent the same cough test.
Results showed that it took almost
twice the concentration of capsaicin to cause the smokers to cough
five or more times as it did the nonsmokers.
In an accompanying editorial, Dr.
Umesh G. Lalloo of the University of Natal in Durban, South Africa,
said many questions about cough remain, and more research is needed
to "decipher the black box that controls the cough reflex."
According to Lalloo, knowledge
of the cough reflex is "scanty," which may explain the lack of
effective cough suppressants for people with persistent cough.
SOURCE: Chest 2003;123:660-662,685-688.
Reference
Source 89
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