Sneeze & Cough Etiquette


Sneeze and cough etiquette may sound self-explanatory, but it’s important we think more about what it means and why we should implement it. Etiquette generally refers to a set of rules or customs that result in a more socially acceptable behaviour in social groups or situations. We also know that sneezing or coughing can result in spreading of germs and sickness.1,2 In the case of sneezing or coughing, using etiquette means taking reasonably practicable steps to minimise the spread of germ-containing saliva droplets to others.2 In this page, we will explore the proper ways to sneeze or cough and how basic steps can help protect those around us, including our family and the community.2

Why Does Sneeze and Cough Etiquette Matter?

There are many reasons why someone might sneeze or cough, and it is a perfectly natural mechanism in the body.3,4,11 We sneeze or cough to remove germs, dust, pollen or other foreign objects from our airways.11 Sneezing or coughing however, also means any germ-containing saliva droplets are rapidly expelled from our mouths and into the air around us.2,11 For respiratory airway viruses, like those this give us a cold or flu, sneezing and coughing allows them to easily spread from person-to-person.2,5,11 Sometimes it’s difficult to avoid a sneeze or cough, as they can come on suddenly. But by practising sneeze and cough etiquette, we can somewhat limit the spread of germs.2

How to Practise Proper Sneeze and Cough Etiquette

Whether at home, in the community or at work, there are some do’s and don’ts when it comes to proper sneeze and cough etiquette.2,6,7 The next section will look at how to sneeze properly, how to cover a cough or sneeze or the proper way to cough. We’ll also touch on the importance of tossing dirty tissues, hand washing and isolating oneself when sick.2,6

Sneeze & Cough into a Tissue or Your Elbow

It’s important to cover a cough or sneeze using a tissue or if the cough or sneeze comes without warning, then into your elbow.6 This is important for two reasons; by covering a cough or sneeze with a tissue, this can catch droplets which means others around us are less likely to pick up germs.6,11 It also means our hands may have less germs on them until they can be washed thoroughly.6,11

If a tissue isn’t available, then it’s better to sneeze or cough into your elbow rather than your hands.6 Why is this important? Contaminated hands can transfer germs to other surfaces, and some germs can survive for hours to days on certain surfaces.1 These can then be picked up by unsuspecting people who may touch the same surface.2 They can then become infected once they transfer the germs from their hands to their face.2,6 So sneeze or cough into your elbow, as this means less chance of placing any germs onto your hands and it’s also another way to practice sneeze and cough etiquette.6

Toss Dirty Tissues

Once a tissue has been used for a sneeze or cough, it is very important not to keep it but to throw it away where others are unlikely to touch it.7 As mentioned earlier, some germs are hardy and can survive up to several days on surfaces.1 So keeping or reusing a used tissue that has already been used to cover a cough or sneeze could mean germs will eventually get onto your hands.1,7 Also having used tissues lying around after a sneeze or cough, means others may pick up germs and get sick.7 Remember that tissues are meant to be used then thrown, so throwing them away straight away is how we can also practice good sneeze and cough etiquette.7

Wash Hands

Even if you sneeze or cough into a tissue or your elbow, another way to practice good sneeze and cough etiquette is hand washing.6,7 Contaminated hands are a common way to pass germs around, and as we now know, these can lurk around on surfaces for up to several days.1,2

Thoroughly washing hands by using soap, scrubbing for enough time, and rinsing are all important for general hygiene and for following sneeze or cough etiquette.2,8 Soap is especially important as the surfactants it has help lift soil and oils from skin whilst lathering and scrubbing hands creates friction and movement.2,8 Various germs can also be present on all surfaces of the hand, especially under the nails.8 So after a sneeze or cough, whether into a tissue or an elbow, the entire hand should be scrubbed.2,8 It is recommended that both hands be scrubbed for at least 20 seconds and a good timer can be humming happy birthday twice to make sure enough time has passed.8 Hands should be rinsed well under clean running water, and then dried using a clean towel if available or air drying.8

Alcohol based sanitisers have been shown to be effective against germs if used according to the instructions on the label.2,9 When out-and-about, hand sanitisers can be an effective way to follow sneeze and cough etiquette.2,9 However, they may not be as effective if hands are grossly dirty or have chemicals on them.2,9 It’s important to use enough sanitiser to effectively cover hands, but sanitisers shouldn’t replace proper hand washing with soap and water - both have their place.2,9

Keep Distance from Others

Social distancing is another example of using sneeze and cough etiquette, especially if someone is sick.2,10 Social distancing involves moving away from others before a cough or sneeze, to help prevent the spread of any germs to others.10 When someone is unwell, and has a regular cough or sneeze, then isolation means they should also be away from others during recovery.10 Having the option of sleeping in a separate room, or using separate facilities, can also help limit spread too.10



This article is for general information only and not intended as a substitute for medical advice.

Strepsils: For temporary relief of sore throats and symptoms of inflammation.

Always read the label. Use only as directed. If symptoms persist see your healthcare professional. Reckitt Benckiser, Auckland


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