The causes of cough with black sputum after two years of smoking cessation include bronchiectasis, pneumonia, lung cancer, respiratory bleeding or inhalation of dust. 1. Bronchodilatation: caused by bronchial obstruction, hereditary factors or respiratory tract infections, etc. Symptoms of the patient can be manifested as cough with black sputum, fever or chest pain, etc. Pneumonia: mainly due to bacteria, fungi or viruses. 2. Pneumonia: mainly caused by bacterial, fungal or viral infections, patient’s symptoms may include chest tightness, shortness of breath, fever, irritability or cough with black sputum. 3. Lung cancer: the cause of the disease is still unclear, patients may not only show the symptoms of cough with black sputum, but also have fever or hoarseness and other symptoms. 4. Respiratory bleeding: when patients suffer from hemoptysis due to bronchial dilatation combined with infection, lung cancer, pulmonary tuberculosis and other causes, the old bleeding can be manifested as black sputum. 5. Inhalation of dust, dust: if the work or living environment of long-term exposure to dust, dust, may also cough up black sputum. The patient has quit smoking for two years, but there are many other reasons for coughing up black sputum, so we recommend that you go to the hospital in time to get a clear picture of the cause of the disease and then give targeted treatment.