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Cough reflex important to preserve upper airways from foreign objects and accumulation of mucus however, postoperative cough, is uncomfortable, distressing sequelae. Coughing affect surgery results, causing potentially dangerous patient movements, and increase wound bleeding. Anaesthetists aim to increase patients comfort and reduce coughing complications. Using simple, easy, cheap and acceptable methods with negligible side effects. This book evaluate the efficiency of endotracheal tube (ETT) lidocaine slow instillation in comparison to normal saline for diminishing smokers cough providing new knowledge about lidocaine instillation method and effect.