Can Alcohol Cause a Persistent Cough and Breathing Problems?

We're all familiar with "smoker's lung" — that distinctive hacking, wheezing cough that deters many from ever picking up a cigarette. But what about a "drinker's cough"? Is that actually a thing? If you're experiencing a nagging morning cough that persists and worsens over time, that regular glass (or bottle) of wine probably isn't your first suspect. Yet "alcoholic cough," shortness of breath after drinking, and even signs of lung failure can all indicate alcoholic lung disease. Let's examine this lesser-known respiratory condition more closely.

How Alcohol Affects Breathing

It's well-established that alcohol damages multiple body systems. It harms the liver, crosses the blood-brain barrier, suppresses neural activity, and disrupts sleep patterns. But what about its impact on breathing?

Alcohol affects our lungs through both direct and indirect mechanisms. Let's first explore the direct effects.

A Quick Look at Lung Function

Our lungs are remarkably sophisticated organs. According to the National Heart, Lung, and Blood Institute, they're "a pair of spongy, pinkish-gray organs in your chest" that serve as the "centerpiece of your respiratory system." They filter incoming air, deliver oxygen to the blood, and remove carbon dioxide with each exhalation.

Inside the lungs, air-carrying tubes called bronchi branch into smaller bronchioles, which end in tiny air sacs called alveoli. These microscopic alveoli are where the crucial gas exchange occurs.

Alveoli are balloon-like structures surrounded by capillary networks. When air reaches the alveoli, oxygen passes through their thin walls into the blood, while carbon dioxide moves from the blood into the alveoli to be exhaled. This gas exchange is essential for life — as anyone who's tried holding their breath knows, we quickly become desperate for air.

Alcohol's Direct Impact on Lungs

Alcohol significantly damages the body, and the lungs are particularly vulnerable. Emory University pulmonologist David Guidot has dedicated his career to studying how alcohol use disorder (AUD) affects the lungs. He explains that "The lungs are especially vulnerable because chronic drinking depletes them of glutathione, and the alveoli and small airways are very dependent on it. Normally, they have 1,000 times more glutathione than other body parts. Chronic alcoholics have extremely low levels of glutathione in the lungs."

While alcohol itself isn't the direct cause of these changes, the oxidative stress it creates leads to glutathione depletion.

Why does glutathione matter? It's a crucial antioxidant that keeps lungs healthy and protected from harmful substances. It also helps create and maintain T-cells, which are essential for proper immune function.

Long-Term Respiratory Effects of Drinking

Chronic alcohol abuse and the resulting glutathione depletion can damage cells lining the respiratory tract, potentially leading to acute respiratory distress syndrome (ARDS). This severe lung failure condition can be life-threatening, occurring when chronic inflammation causes fluids and inflammatory cells to accumulate in alveolar spaces. The consequence? Clogged airways that make gas exchange less efficient.

Over time, oxygen deprivation can seriously impact health. If unaddressed, it may lead to organ failure and other life-threatening complications. Additional factors like infections, injuries, or inhaling stomach contents during severe intoxication can worsen the situation.

The AUD-ARDS Connection

The link between ARDS and alcohol was first identified in 1996 by a University of Colorado team led by Marc Moss. Through laboratory studies, they demonstrated how alcohol affects glutathione levels and lung function.

Current research by scientists like Guidot continues to reveal new details about "alcoholic lung disease." One study tracking alcoholic patients hospitalized in Atlanta, Denver, and Seattle found the correlation between AUD and ARDS was stronger than previously thought. Guidot noted, "The relative risk of ARDS for those with alcohol abuse was closer to 4 to 1 than the 2 to 1 risk identified in the original 1996 study... The results were dramatic."

Another relevant study examined glutathione levels in "relatively functional alcoholics" — young people treated for AUD who were otherwise healthy and well-nourished. Researchers found their lung glutathione levels were 80-90% lower than non-drinkers 2-3 days after their last drink and remained low for at least a week.

Alcohol and Respiratory Infections

Beyond impairing oxygen delivery, alcohol interferes with the lungs' immune function. The respiratory tract contains cilia — tiny hair-like structures that sweep pathogens and harmful particles out of airways along with mucus.

Alcohol impairs these microscopic cleaners, increasing susceptibility to lung-targeting diseases like pneumonia and tuberculosis. This represents an indirect but equally damaging attack on lung health.

Alcoholic Pneumonia

Bacterial pneumonia, often called "alcoholic pneumonia" when related to AUD, is one of the most common and serious complications. According to the NIH, pneumonia is lung inflammation caused by bacterial infection (though fungi, viruses, and parasites can also cause it).

Pneumonia can be serious for vulnerable populations, and alcohol exacerbates the risks. The CDC notes that pneumonia is four times more likely to be fatal for people who abuse alcohol.

Tuberculosis and AUD

Mycobacterium tuberculosis infections (which cause TB) pose particular threats to people with AUD. According to the WHO, TB is the world's second-leading cause of death, claiming over a million lives annually. While TB often remains dormant in healthy individuals, those with alcohol-weakened immune systems are more likely to develop serious symptoms.

RSV and AUD

While bacterial infections receive more attention regarding alcohol-related lung complications, viral infections are also concerning. Respiratory syncytial virus (RSV) typically affects the lower respiratory tract and is common in children, older adults, and people with AUD. Since alcohol impairs cilia function — the "first line" defense against pathogens — RSV finds easier entry into the respiratory system.

Signs of Alcoholic Lung Disease

If you suspect alcoholic lung disease, watch for these symptoms (most relevant to ARDS, though some may indicate alcohol-weakened immune responses):

• Shortness of breath: Difficulty breathing, especially during exertion like climbing stairs
• Chronic cough and wheezing: Persistent coughing (dry or productive) and wheezing indicating airway obstruction
• Weakness and fatigue: Unusual tiredness from inadequate oxygen supply
• Unexplained weight loss: Unintentional weight reduction potentially signaling chronic lung disease
• Chest pain: Discomfort indicating severe lung conditions or infections
• Frequent infections: Recurrent respiratory illnesses as lung condition progresses

These symptoms shouldn't be ignored. If you experience them, seek medical evaluation promptly.

Can Alcoholic Lung Damage Be Reversed?

Recovery potential varies. Early-stage damage might be reversible, while extensive damage may be permanent — though treatment can still help manage symptoms.

For acute conditions worsened by alcohol (like pneumonia), recovery is usually possible with prompt treatment:

• Stop drinking to support immune system recovery
• Take prescribed medications (typically antibiotics)
• Use ventilator support if necessary for breathing issues
• Receive appropriate aftercare and rehabilitation

For chronic conditions or repeated ARDS episodes, complete reversal might not be possible. However, reducing alcohol consumption and receiving proper medical care can help manage symptoms and slow progression.

The common factor in all recovery scenarios is changing your relationship with alcohol. If alcohol has landed you in the hospital with serious infections, it's time to reassess your habits. Many people have successfully navigated this journey — you can too! Quitemate is available to support you throughout the process.

Tips for Healthy Breathing

To maintain respiratory health and prevent issues:

• Boost antioxidant intake: Eat plenty of fruits and vegetables containing lung-protective antioxidants like allium sulfur compounds (leeks, onions, garlic), anthocyanins (eggplant, grapes, berries), and flavonoids (apples, onions, citrus fruits)
• Exercise regularly: Aerobic activities like walking, jogging, swimming, or dancing improve lung capacity
• Avoid smoking: Smoking causes numerous serious health conditions including cancer, heart disease, stroke, and COPD
• Limit outdoor pollution exposure: Monitor air quality alerts and adjust outdoor activities accordingly
• Improve indoor air quality: Maintain no-smoking policies indoors, avoid harsh chemicals, and consider air purifiers if sensitive to pollutants

Following these tips can help prevent respiratory issues and improve lung function. If you need support changing your alcohol relationship to protect your long-term lung health, Quitemate can help!