Coughing and sneezing are your airways doing their job. Stifling them can hurt you, and most of what’s sold to stop them doesn’t do much. Here’s what the evidence says, and the simple habit that solves the social problem.
The grades in this post: Strong means good randomised trials agree. Mixed means trials disagree, are small, or are low quality. Modelling or case reports means computer models or individual cases, not trials. NHS means current NHS advice.
The short version
- Coughs and sneezes are protective reflexes. They clear irritants, mucus and microbes from your airways.
- Don’t hold a sneeze in. Pinching your nose and closing your mouth multiplies the pressure in your airways, and there are case reports of real injuries.
- Direct it instead: into a tissue, or the crook of your elbow. That deals with other people without fighting your own body.
- Over-the-counter cough medicines: no good evidence for or against them in adults; in children, most did no better than placebo.
- Honey has the best evidence of the home remedies (not for babies under 1).
- A cough after a cold lasts about two and a half weeks on average, longer than most people expect. See your GP if it’s past three weeks.
What they’re for
A sneeze clears your nose; a cough clears your throat and lungs. Both are reflexes: a fast, forceful blast of air triggered by irritation from dust, pollen, cold air, mucus or an infection. They’re part of how your body keeps the airways clean, alongside the mucus that traps things and the tiny hairs that move it along.
That’s why “stop the cough” isn’t always the right goal. A dry, tickly cough that keeps you awake is worth easing. A cough that’s clearing mucus is doing something useful.
Why you shouldn’t hold in a sneeze
The social pressure is real: nobody wants to be the person who sneezes on the bus. So people pinch their nose, clamp their mouth shut and swallow it.
The physics. In a computer model of a real person’s airways, a normal sneeze pushed the pressure in the windpipe to about 7,000 Pa, compared with about 200 Pa in a hard breath out. Holding the nose or closing the mouth raised the pressure difference in the airway to 5 to 24 times that of a normal sneeze (Rahiminejad 2016). Modelling
The injuries. A fractured bone in the middle ear, causing hearing loss (Zhao 2019). Air inside the skull (Munshi 2023). Air under the skin of the face, which revealed a sinus fracture from a minor knock the day before (Strea 2022). Case reports These are rare. But the risk is all on one side: there’s no benefit to holding it in.
Let it out, into a tissue or the crook of your elbow, turned away from people. Then bin the tissue and wash your hands. You’re not choosing between your body and other people. (This is practical advice, not something trials have tested.)
What actually helps a cough
| What | What the trials show | Grade |
|---|---|---|
| Over-the-counter cough medicines | A Cochrane review of 29 trials (4,835 people) found “no good evidence for or against” them. In adults, results were mixed by type. In children, antitussives, antihistamines and antihistamine-decongestants did no better than placebo. Side effects were more common with antihistamines and dextromethorphan (Smith 2014). | Mixed adults; no benefit in children |
| Honey | In a review of 14 studies, honey beat usual care for cough frequency and severity (Abuelgasim 2020). In children, honey probably reduced cough frequency more than placebo or no treatment, and did about as well as dextromethorphan, mostly over a single night (Cochrane, Oduwole 2018). Placebo-controlled trials in adults are few. | Moderate children; mixed in adults |
| Steam / heated humid air | A Cochrane review of 6 trials (387 people): it’s uncertain whether it relieves cold symptoms, because the result depended on how the data were analysed. No benefit or harm shown (Singh 2017). | Mixed low quality |
| Exercising through a cold | Fifty young adults were given a cold virus. Those who exercised moderately every other day had no worse symptoms and no longer illness than those who rested (Weidner 1998). One small study of healthy young adults with a mild cold. | One small trial |
Honey is not suitable for babies under 1, and the NHS advises against hot drinks for small children.
A note on fever. Bringing a temperature down with paracetamol or ibuprofen makes you feel better, and that’s a good reason to use it. One modelling study estimated that widespread fever-lowering could slightly increase the spread of flu, perhaps because people feel well enough to go out while still infectious (Earn 2014). Modelling The authors describe their data as incomplete. The practical point isn’t “don’t treat a fever”; it’s that feeling better isn’t the same as not being infectious.
How long it should last
People expect a cough to last about a week. In the research, the average acute cough lasted 17.8 days (Ebell 2013). The NHS says a cough “will usually clear up on its own within 3 to 4 weeks”, and to see a GP if you’ve had a cough for more than 3 weeks. Knowing that saves a lot of worry, and a lot of antibiotics that wouldn’t help a viral cough anyway.
| What people expected | 7–9 days |
|---|---|
| What the research found | 17.8 days |
When to get help NHS
See a GP if:
- you’ve had a cough for more than 3 weeks;
- you’re losing weight for no reason;
- you have a weakened immune system, for example because of chemotherapy or diabetes.
Ask for an urgent GP appointment or get help from NHS 111 if:
- your cough is very bad or quickly gets worse, for example a hacking cough or you can’t stop coughing;
- you feel very unwell;
- you have chest pain;
- the side of your neck feels swollen and painful (swollen glands);
- you find it hard to breathe;
- you’re coughing up blood.
In an emergency, call 999.
Where I land
Let it out, point it somewhere sensible, and don’t spend much on bottles that promise to stop it. Honey in a warm drink is cheap and has the best evidence of the home options. Expect a cough to hang around for two or three weeks, and know the signs that mean it’s more than a cold.
If you’re the person who catches everything going, every winter, that’s a different question: why some people get ill more than others, can you really catch a cold?, and my own story of getting properly ill.
Sources
- Abuelgasim H et al. Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis. BMJ Evid Based Med 2021;26:57–64. PMID 32817011. doi:10.1136/bmjebm-2020-111336
- Earn DJD et al. Population-level effects of suppressing fever. Proc Biol Sci 2014;281:20132570. PMID 24452021. doi:10.1098/rspb.2013.2570
- Ebell MH et al. How long does a cough last? Comparing patients’ expectations with data from a systematic review of the literature. Ann Fam Med 2013;11:5–13. PMID 23319500. doi:10.1370/afm.1430
- Munshi NH, Ramakrishnan V. Pneumocephalus following sneeze suppression. Radiol Case Rep 2023;18:1527–29. PMID 36815145. doi:10.1016/j.radcr.2023.01.057
- NHS. Cough. nhs.uk/symptoms/cough (page last reviewed 8 December 2023; read 15 October 2026).
- Oduwole O et al. Honey for acute cough in children. Cochrane Database Syst Rev 2018;4:CD007094. PMID 29633783. doi:10.1002/14651858.CD007094.pub5
- Rahiminejad M et al. Computer simulations of pressure and velocity fields in a human upper airway during sneezing. Comput Biol Med 2016;71:115–27. PMID 26914240. doi:10.1016/j.compbiomed.2016.01.022
- Singh M et al. Heated, humidified air for the common cold. Cochrane Database Syst Rev 2017;8:CD001728. PMID 28849871. doi:10.1002/14651858.CD001728.pub6
- Smith SM et al. Over-the-counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database Syst Rev 2014;11:CD001831. PMID 25420096. doi:10.1002/14651858.CD001831.pub5
- Strea J et al. Traumatic subcutaneous emphysema of the face: the hazard of holding a sneeze [in French]. Rev Med Liege 2022;77:481–83. PMID 36082591. (No DOI.)
- Weidner TG et al. The effect of exercise training on the severity and duration of a viral upper respiratory illness. Med Sci Sports Exerc 1998;30:1578–83. PMID 9813869. doi:10.1097/00005768-199811000-00004
- Zhao NW et al. Isolated malleus fracture from sneezing: a case report. Cureus 2019;11:e5037. PMID 31501729. doi:10.7759/cureus.5037