A hacking cough is a part of frequent throat clearing due to acid reflux
. The little off white balls that you are hacking up can be:
2. Dead white blood cells due to infection or allergy.
3. Fungal Balls.
4. Excessive Mucus due to post nasal drip
5. Bits of 'biofilm'.
Get these cough balls examined, if possible, at a Microbiology/Pathology Lab. to determine their origin. Do they have a foul smell?
Smoking irritates the nose and throat. It damages the delicate cilia of the nasal and respiratory lining. It will also irritate the Eustachian tube and cause clogging of your ears. Have you had a Ear Impedance Audiometry
/ Tympanometry? Your symptoms may be as a result of a combination of acid reflux and smoking. A bad or stale batch of cigarettes stored in high humidity may also contain bacteria, yeast and fungi.