Why You Smell Phantom Cigarette Smoke When Nobody’s Smoking

Nobody around is smoking, so why do you smell cigarette smoke? Is this crazy or what? There are some explanations for this phenomenon.
“There are many reasons that cause people to have phantom smells and/or bad smells (known as parosmia),” explains Jordan S. Josephson, MD, Ear, Nose and Throat Specialist at Lenox Hill Hospital in NY, Author of Sinus Relief Now, Director of the New York Nasal and Sinus Center.

Unfortunately, some causes of smelling cigarette smoke
when nobody is smoking are very serious:

“These phantom smells can be caused by damage to the olfactory nerve by chemicals, or infection with a virus or bacteria, or trauma. A tumor of the brain or the olfactory nerve can also cause phantom smells. Or it can be caused by the infection itself. And the resulting sensation is then confused in the brain with the smell of cigarette smoke.”

More about parosmia: Dr. Josephson notes, “The bottom line is that many people may get this sensation at one time or another. If it comes and goes, then again, there is probably nothing to worry about. However, there are a few conditions that can cause parosmia, and this lasts longer than a fleeting moment, or recurs more frequently, and this is something that needs to be looked at carefully.” 

Why is cigarette smoke usually the phantom smell? “The parosmia is often described like the smell of smoke or cigarette smoke or like something that is burning. Overall this symptom is poorly understood and we don’t know why people relate this to cigarette smoke. It may be that the neurologic signals sent to the brain by the damage is closest to what we have learned is the smell of cigarette smoke or something burning.”  

If one has parosmia, when should he seek medical attention? “If the parosmia lingers, worsens and does not get better or it occurs with increasing frequency, you should probably see a board certified otolaryngologist and a neurologist and get studies to evaluate the cause of this problem. The good news is there most likely is a solution for most of these sufferers.”

What is it about phantom cigarette smoke and being alone in a car and nobody’s been puffing tobacco? “Many people report that this sensation of parosmia is brought on by dry heated air.  That is probably why many people report this to occur in the car because of the heating system in the car blowing dry air. 

"Boiling water and forced hot air from a furnace have also been reported by many patients to induce this sensation as well.  It is probably that there was damage to the nerve, and the heat causes the nerve to fire and cause this sensation of parosmia.  However, this is not well understood.”

Other causes of smelling cigarette smoke are infections that can invade the sinuses or throat. These can harm the nerves that pick up scents. Dr. Josephson explains, “This is usually following a sinus infection or an upper respiratory tract infection.” 

He continues, “If it is a bacterial sinusitis it needs to be treated with antibiotics, irrigation with saline and topical steroid sprays.  Furthermore, viruses that attack the olfactory nerve or taste nerve can lead to this sense of something burning. Migraines can also be related to an aura that brings on the sensation of something burning or a smell described like there is cigarette smoke when there is none.”

If you continue to smell cigarette smoke, Dr. Josephson urges a comprehensive workup which includes a smell test and CAT scan. “Then appropriate treatment has to be instituted. And the cause may be multi-factorial and therefore the treatment may need to be multifaceted.” Unfortunately, two more causes could be neurological conditions including stroke.