Whether primary or secondary pneumothorax, smoking increases the likelihood of bleb rupture and recurrence, and it does so in a predictable, dose-related manner. Relative risk of bleb rupture and recurrence rises by up to a factor of 20.

Does smoking cause lung blebs?

The association between tobacco-induced respiratory bronchiolitis and focal emphysema with consequent formation of blebs/bullae remains to be studied. The rate of recurrence after the first episode of primary spontaneous pneumothorax was higher in smokers than in nonsmokers.

What causes lung blebs?

Blebs may be present on an individual's lung (or lungs) for a long time before they rupture. Many things can cause a bleb to rupture, such as changes in air pressure or a very sudden deep breath.