Hi, welcome to HCM. Thanks for asking your query at this forum. We understand your concern. I have read your question carefully and understood it. I will try my best to answer it. Smoking regularly for 40 years is very dangerous and it may lead to chronic bronchitis/COPD/Emphysema/bronchiectasis or carcinoma. Already your father was on spiriva (Tiotropium bromide) which is a medicine for COPD. So, apparently he already had features of COPD since last many years. Although he had stopped smoking 10 years ago, the effect on lungs are of chronic nature. In chronic bronchitis, there may be superimposed acute bronchitis due to upper respiratory tract infection/ allergy etc. Whenever it happens it causes exacerbation of cough and sputum production along with pain in chest, shoulder, abdominal and back muscles due to recurrent coughing. Minor blood in sputum is common in this condition. Apparently this is happening with your father. He may be needed to be examined physically before prescription of few short term antibiotics and antiallergic medicines along with up-titration of ongoing COPD medications. I hope it answers your query. I wish your father a better health.