Can living at a higher altitude cause spontaneous pneumothorax?

No: Pneumothorax is a risk with barotrauma occurring during rapid changes in pressure causing the lung to overexpand. For example if a scuba diver is at depth takes a deep breath and comes up from the high pressure depth to low pressure at surface, the lungs will overexpand. As pressure decreases, volume of air in lungs increase>barotrauma. Living at constant pressure at high altitude is ok.

Generally no.: Living at higher altitude is not regarded as an independent risk factor for spontaneous pneumothorax. The risk factors for primary and secondary spontaneous pneumothorax (sp) include: smoking (including marijuana), tall thin stature in otherwise healthy, connective tissue disorders, pregnancy, familial history. Lung inflammation is also hypothesized to be important.