Nondrug interventions for chronic cough in adults

Minimising environmental factors

Advise patients to avoid exposure to environmental factors that may be contributing to or worsening their cough. This includes exposure to cold dry air, environmental tobacco smoke and other inhaled irritants.

Smoking cessation should be strongly recommended; see Smoking cessation. Warn patients that cough may temporarily increase during smoking cessationCummings, 1985 Morice, 2020.

Vocal hygiene

In patients with chronic dry cough, vocal hygiene measures are aimed at reducing further laryngeal irritation (and upper airway hypersensitivity), which may be perpetuating the urge to cough. Strategies include:

avoiding overuse of the voice
avoiding smoky or polluted environments
avoiding clearing the throat and minimising coughing (eg by taking sips of water with a hard swallow)
having a family member draw attention to unwitting habitual coughing or throat-clearing
referring to a cough clinic or speech pathologist for training in techniques to relieve glottal constriction during inspiration, and to recognise and alter the response to triggers.

Sputum clearance

For patients with a chronic productive cough, training in ‘Active Cycle of Breathing’ techniques can improve sputum clearance by moving secretions towards the mouth so they can be cleared. This can reduce irritation to the larynx (and upper airway hypersensitivity) caused by repetitive coughing.

Patient information about Active Cycle of Breathing for patients with chronic productive cough is available from the Bronchiectasis Toolbox website.