9 Symptoms Never to Ignore If You Smoke

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  • Smoking-cigarette

    More than 34 million adults in the United States smoke, despite decades of public health warnings about the health risks. If you smoke, consider getting help to break the habit, but in the meantime, be aware of symptoms of serious smoking-related illnesses. The sooner you see a doctor, the higher the likelihood you can address the severe and potentially fatal consequences that come from using tobacco products.

  • 1
    Persistent Cough

    A “smoker’s cough” is a cough that lasts more than three weeks in people who smoke. It tends to be worse in the morning and improves during the day. You may notice increased phlegm and crackling or wheezing sounds when you breathe. A persistent cough could mean you have COPD (chronic obstructive pulmonary disease), like emphysema or chronic bronchitis. It could also be a sign of lung cancer, which accounts for a quarter of all cancer deaths in the U.S.

  • 2
    Chest Pain
    Middle aged woman on bed with chest pain

    If you smoke and have chest pain that worsens when you laugh, cough or breathe deeply, it could be a sign of heart disease such as arteriosclerosis (hardening of the arteries) or atherosclerosis, a type of arteriosclerosis in which a buildup of plaque in your blood vessels can lead to a dangerous clot. Narrow arteries put a strain on the heart that can cause a heart-related pain called angina. If an artery becomes completely blocked, you can have a heart attack. Smoking also increases your risk of developing atrial fibrillation (afib), an irregular heartbeat that can cause chest pain and lead to stroke. Chest pain or tightness can also be a sign of lung disease such as COPD or lung cancer.

  • 3
    Shortness of Breath
    Man struggling with flu like symptoms in the kitchen

    Smoking damages your airways, including the large air sacs (bronchi) that bring air into the lungs and small air sacs in your lungs (alveoli) that deliver oxygen to your bloodstream. If you smoke and feel short of breath, it could be a sign of lung disease like COPD, which includes emphysema or chronic bronchitis. Smokers are more than 10 times more likely to die of COPD than those who do not smoke. Lung cancer, which is too often diagnosed after it has progressed, also causes shortness of breath. Tobacco smoke can trigger asthma attacks that also affect your ability to breathe well.

  • 4
    Bloody Phlegm

    Bloody phlegm can be a sign of a serious health problem, especially if you are a smoker. It’s a mixture of saliva and blood that you cough up from your lungs, and though it isn’t always a symptom of severe illness, it’s a good idea to contact your healthcare provider for a diagnosis. It could be chronic bronchitis, a form of COPD in which your large airways (bronchi) become inflamed. Bloody or rust-colored phlegm can also be a sign of lung cancer, pneumonia, or other lung conditions associated with smoking.

  • 5
    Unexplained Fatigue
    Businessman asleep on train

    If you smoke and feel tired much of the time, it could be a sign of several health conditions related to tobacco use. Smoking damages your lungs and heart, and when these vital organs are not working at capacity, your body is not getting the oxygen it needs for you to have stamina and energy. If you stop smoking, you may be able to reverse some of the damage that smoking causes, improve your health, and increase your life expectancy. Your healthcare provider can help diagnose the cause of your fatigue and may also be able to provide you with information to help you stop smoking.

  • 6
    Recurring Lung Infections
    Senior woman at home with cough and cold

    The chemicals in tobacco smoke and other tobacco products harm the immune system, making you more vulnerable to lung infections including pneumonia; meningococcal disease, including meningitis and sepsis; tuberculosis; HIV; COVID-19; and other bacterial or viral infections. Some common symptoms of lung infections are thick mucus, sharp chest pains, and wheezing accompanied by fever, aches, shortness of breath, and fatigue. Recurrent lung infections can also be a sign of lung cancer, which is the leading cause of cancer death among smokers.

  • 7
    Swelling in Face or Neck
    Woman looking in bathroom mirror, touching neck

    If you smoke and notice swelling in your head or neck, don’t ignore it. Smokers have a higher risk of lung cancer, and a tumor in the lung may press on a vein called the vena cava that runs from the head to the heart. If the vein is constricted, it can cause your face to swell. Related symptoms of vena cava obstruction include shortness of breath, and a reddening of the skin on your neck or face. Head and neck cancers, which are more common in smokers, can also cause swelling. Head and neck cancers are often curable if caught early.

  • 8
    Hoarse Voice
    Midsection Of Woman With Sore Throat

    If your voice is chronically hoarse, it may be due to a smoking-related disease of the throat or larynx. Laryngeal cancer can spread to other parts of the body, such as the back of the tongue and your lungs, and smokers carry a higher risk of premature death from laryngeal cancer. Tumors in the left lung (or less commonly in the right lung) can press on a nerve that leads from the larynx, which can also cause hoarseness. Hoarseness may also be due to polyps, which smokers are prone to develop.

  • 9
    Leg Cramps
    Senior man massaging knee pain

    If you smoke and experience leg cramps when you walk, it could be a symptom of peripheral artery disease. This condition develops when a buildup of fatty deposits narrows the arteries that supply blood to your extremities, an effect of harmful substances in tobacco smoke. Peripheral artery disease also increases your risk of stroke, so tell your healthcare provider about any leg cramps you have, especially if you are a smoker.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 4
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.