Chronic Bronchitis and Smoking Cessation

Definition and Diagnosis

• Chronic bronchitis is the actual medical diagnosis for smokers with chronic cough and sputum production occurring on most days for at least 3 months and for at least 2 consecutive years, with cigarette smoking responsible for 85-90% of cases 1, 2
• The American College of Chest Physicians recommends diagnosing chronic bronchitis and strongly recommending smoking cessation for actively smoking patients with chronic productive cough 1, 2

Pathophysiology and Risk Factors

• Smoking impairs immune defenses through multiple mechanisms: increased inflammation, impaired mucociliary clearance, increased epithelial permeability, and suppressed macrophage function 3, 4

Clinical Presentation

• Influenza presents with abrupt onset of fever, myalgia, headache, malaise, nonproductive cough, sore throat, and rhinitis, with current smokers being over 5 times more likely to develop laboratory-confirmed influenza than non-smokers 5

Management and Treatment

• The American College of Chest Physicians recommends reassuring patients that symptoms will improve rapidly after smoking cessation, with most resolving within 4 weeks of cessation 6