There are many reasons for a strong cough from smoking, commonly associated with chronic pharyngitis, chronic bronchitis, chronic obstructive pulmonary disease, and lung cancer. 1. Chronic pharyngitis: chronic pharyngitis is a chronic diffuse inflammation of the pharyngeal mucosa and submucosal tissues, which often has a long course of disease and recurs over a long period of time. Smoking can stimulate the pharyngeal mucosa, exacerbate the inflammatory response, and cause the patient to cough and sputum aggravation. 2. Chronic bronchitis: chronic bronchitis is a chronic non-specific inflammation of the bronchial mucosa and surrounding tissues, smoking will stimulate the bronchial secretion increase, damage to the mucosal epithelium of the organ, aggravate cough and phlegm symptoms. 3. Chronic Obstructive Pulmonary Disease (COPD): COPD is diagnosed when patients with chronic bronchitis have persistent airflow limitation on pulmonary function tests. Smoking will further aggravate airway damage, accelerate the development of the disease, and aggravate the symptoms of cough and sputum. 4. Lung cancer: there is clear evidence that smoking is closely related to lung cancer, and the possibility of lung cancer should be highly suspected when there is a history of long-term smoking and unexplained severe cough. If the cough worsens after smoking, it is recommended that the patient should go to the hospital in time to find out the cause of the disease and have standardized treatment under the doctor’s guidance. In addition, smoking is harmful to health, it is recommended to quit smoking as soon as possible.