Why it’s time to ditch the cough ‘cures’ that cost us £2m a month

Spending money on different types of cough medicine is a waste, reports JANE SYMONS

chocolate-based medicine cleared their coughs by day four, compared to 17 per cent of those taking linctus.

Twice as many stopped taking it because their coughs had cleared – 24 per cent compared to just 11 per cent who were given linctus. Professor Morice points out: “It’s the first study to challenge the idea that different types of cough require different medicines, further reinforcing evidence that the traditional method of classifying common coughs as wet or dry is outdated and unhelpful.”

Of the idea that coughs are wet or dry, he argues: “These arbitrary categories are based on what was once best practice for the treatment of tuberculosis and chronic bronchitis and have no place in the modern-day real world where there is no danger of the previously fit patient with acute cough drowning in their own phlegm.”

He says: “From a marketing point of view it’s a sound strategy but from a scientific view it is outdated.

“It is hypersensitivity of the upper respiratory nerves that creates the urge to cough.”

He is now suggesting a new “care pathway”, a series of questions and checks pharmacists should tick off before offering advice on remedies. Top of the checklist is how long you have had the cough.

If a cough has persisted for more than eight weeks there may be a serious underlying problem and it’s wise to see a GP.

Any so-called “red-flag” symptoms such as localised chest pain or coughing up blood or large amounts of sputum, should also be checked out by your doctor. If you have recently had a cold or flu, the most likely cause is acute viral cough.

“The goal of therapy in all acute cough is to reduce cough sensitivity,” says Professor Morice.

However, while the Rococo trial confirmed the efficacy of Unicough, Professor Morice says there is still much to learn about the way chocolate can calm coughs.

Cocoa contains theobromine, a substance which helps to suppress coughs. It also makes the Unicough mixture stickier and more viscous than standard cough medicines.

This acts as what doctors call a demulcent and forms a soothing coating which calms and protects the sensitised nerve endings which characterise cough hypersensitivity.

However Professor Morice explains that there may be other benefits. “We don’t understand all the receptors involved in a mechanism like a cough but I am convinced there is a chocolate receptor and the cocoa is going to have some additional effect.”