When it comes to your airways, smoking affects more than just your lungs. It’s an activity that can weaken your immune system and cause throat irritation, factors that may promote respiratory infections like strep throat.

Strep throat is a contagious infection caused by group A streptococcus bacteria, also known as Streptococcus pyogenes. It’s a common cause of acute (short-term) sore throat, accounting for up to 15% of acute sore throats in adults and 30% of those in children.

If you smoke or are around secondhand smoke, you may have a higher chance of developing strep throat and other respiratory infections.

Regular exposure to smoke can weaken your immune system, irritate your respiratory tract, and reduce other natural defenses, like cilia function.

It’s been established that smoking increases your risk for all respiratory infections and infections in general.

Strep throat is a condition affecting the throat and tonsils. It’s considered an infection of the upper respiratory tract, which includes the structures of the nose, throat, and sinuses.

According to a 2020 narrative review, smoking increases the risk and recurrence rate of upper respiratory tract infections and may extend the amount of time you experience symptoms.

The infection risk to your throat is not limited to traditional cigarettes. Research suggests that vaping and the use of e-cigarettes may also compromise your respiratory system’s ability to fight off viruses and bacteria.

The link between smoking and respiratory infections is complex.

It has to do with how smoking affects your immune responses, your social behaviors during smoking, and the changes smoking causes to your body’s tissues and functions.

Weakened immune system

Smoking weakens your body’s immune system, the natural defense you have against invading pathogens like viruses and bacteria.

It does this by suppressing the activity of immune cells that usually destroy invading pathogens and inhibiting the creation of antibodies, proteins your body uses to fight off future infection.

Having a weakened immune system means that you’re more likely to develop strep throat if you’re exposed to the bacteria, and symptoms may last longer because your body can’t efficiently combat it.

Pro-infection throat environment

Additionally, smoking may increase your chances of contracting group A streptococcus because it creates a pro-infectious environment in the throat.

Smoke is an irritant. According to the National Cancer Institute, it contains more than 7,000 chemicals, of which at least 250 are known to be harmful.

These substances can directly damage the epithelial barrier in your throat. Over time, this damage can reduce your cough reflex intensity, cause excessive mucus production, and impair cilia. Cilia are the hair-like structures in your upper respiratory tract that catch pathogens and foreign particles.

All of these effects can increase the chances of an infection.

Diminished cough intensity limits the ability of your cough to clear unwanted substances from your airways, and too much mucus can end up trapping bacteria and viruses in the throat.

If cilia become paralyzed, particles and infectious agents are free to travel through your respiratory system.

Increased opportunity for infection

Sharing cigarettes is an often overlooked factor in how smoking may increase the chances of upper respiratory infections.

According to a 2022 cross-sectional survey from China, more than half of participants reported receiving a single shared cigarette within the last 12 months. The behavior was seen as a way to welcome guests, engage socially at work, and display common etiquette.

Sharing cigarettes, vapes, or e-cigarettes can put you in direct contact with infected respiratory droplets if someone has strep throat.

Smoking cessation (stopping smoking activities) can reduce your chances of developing strep throat and other infections.

It can also improve your overall lung function, slow the progression of chronic lung conditions, and help manage existing respiratory symptoms like coughing and wheezing.

If you’re ready to change your relationship with smoking, help is available any time by contacting the SAMHSA National Helpline at 1-800-662-4357. A representative can speak with you confidentially and direct you to resources in your local area.

You can also connect with smoking cessation experts by calling 1-800-QUIT-NOW (1-800-784-8669) or texting QUITNOW to 333888.

Smoking can increase your chances of developing strep throat and other respiratory infections.

Along with weakening your immune system, smoking directly affects the tissues of the throat, causing irritation that disrupts typical function and the ability to clear viruses and bacteria.

If you notice frequent infections or that your symptoms last longer when you get sick, it could be related to the use of cigarettes, vapes, e-cigarettes, or exposure to tobacco smoke.

Smoking cessation can reduce your risk for respiratory infections and improve your overall lung function.