Age 31 plus 10 year history of smoking still places you ate very low risk for lung cancer
Your description of tiny blood spots within sputum is not very suspicious either ...
When a smoker does quit there may often be about 2 months folowing INCREASE in cough as the cilia that clear the airways are renewed and begin to function better again to bring mucus up from deep in the lungs ...
That aspect is common..
Cough of frank blood would be more serious and unusual
If that should be the cause then referral to a pulmonologist and a chest CT would be in order
Anxiety I agree frequently plays a huge factor in what you notice and perceive as to your health
In your case perhaps the anxiety will at least help you to kick the habit
Risk of lung cancer in average smoker ( which would be more than 20 pack / year history ) would lead to a 10 percent lifetime risk of lung cancer ...
At your age we extremely uncommonly see lung cancer and that explains why your PCP would not suspect that diagnosis with you ..
Give it time -- do kick the habit -- expect as I said more cough and some brownish mucus for a couple of months as typical ..
If you develop other concerning symptoms then you may of course folow up with your doctor or see a pulmonologist
These steps at this time to me seem unnecssary and overkill however
If you have more in terms of coughing up bright streaks of blood or worse then I would suggest response to that with a chest CT / pulmonologist referral / probable bronchoscopy
What you describe does not seem to rise to this level of concern though
I hope that this is helpful for you
Let me know if you have further questions or concerns
I will be happy to get back with you
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Thank you and Best Regards,
Anthony Bray MD