Asthma and smoking

If you have asthma, smoking can lead to more frequent and more severe flare-ups, worse asthma control and less benefit from some treatments. It can also limit how active you are and reduce your quality of life.

Smoking damages your airways, causing inflammation and a faster loss of lung function. Lung function is a measure of how much air you can breathe in and out of your lungs, and how hard and fast you can breathe out.

How smoking harms the lungs#

Your lungs are lined by tiny hairs called cilia. These move in a wave-like motion to sweep dust, pollens and other irritants out of your lungs.

Cigarette smoke damages these tiny hairs. As a result, your lungs are less able to clean themselves, so mucus and toxic substances can collect in the lungs and increase the risk of infection.

Smoking can also damage the small airways and air sacs within the lungs, causing lung disease such as emphysema. As lung disease slowly worsens over time, it can limit airflow and cause shortness of breath.

Quitting smoking reduces your risk of developing lung disease, and slows down any worsening of lung disease if you already have it. Within weeks to months, stopping smoking may improve lung function, reduce asthma symptoms, lower your use of asthma inhalers, improve your response to treatment and improve overall asthma control.

Second-hand smoke#

Breathing in other people’s cigarette smoke can be harmful to people with asthma, especially children. Second-hand smoke can reduce lung function and trigger flare-ups.

If a woman smokes while she is pregnant, the chemicals in the cigarette smoke pass to the developing baby through the umbilical cord. The baby’s lungs can be affected, which increases the risk of weaker lungs and wheezing symptoms early in life. Smoking during pregnancy also causes many other problems, such as low birth weight and premature labour, and increases the risk of fetal death and stillbirth.

Children exposed to second-hand smoke are more likely to develop asthma in childhood. They tend to have more severe symptoms, more frequent flare-ups and poorer lung function. They are more likely to be admitted to hospital because of asthma and to need asthma medications.

Children of people who smoke are also more likely to develop chest infections and other illnesses. Viral chest infections in infancy increase the risk of developing asthma in childhood, especially among infants who are sensitised to allergens.

Reducing your risk#

You can reduce the risk of worsening your asthma by avoiding cigarette smoke. Some suggestions include:

• Quit smoking.
• Make your home completely smoke free, and ask guests not to smoke in your house.
• Avoid smoky places, such as the outdoor areas of pubs, bars and cafes.

If you wish to use nicotine replacement therapy or medications to help you stop smoking, talk to your doctor or pharmacist about which products are suitable for you. It is important to discuss your options before you start.

If you can’t always keep away from smoky places, it is important to manage your asthma on a daily basis. Remember to take your reliever medication with you when you visit a smoky place. If you need to use your reliever medication more than twice a week (excluding doses taken before exercise), see your doctor, as your treatment may need to be adjusted.

People with asthma have sensitive airways inside their lungs, and certain triggers can set off a flare-up. Avoiding smoke is one way to keep those airways calmer and your asthma better controlled.

Key points#

• Children exposed to smoke tend to have more severe symptoms, more frequent flare-ups and poorer lung function.
• You can reduce the risk of worsening your asthma by avoiding cigarette smoke.
• Before using products to quit smoking, speak to your doctor or pharmacist about your options.
• If you can’t always keep away from smoky places, it is important to manage your asthma on a daily basis.

Where to get help#