Asthma and Smoking: an Unfortunate Combination

Asthma and Smoking: an Unfortunate Combination


If you have asthma, smoking can lead to more asthma symptoms, more frequent asthma attacks, worse asthma control and less benefit from some asthma medications. Smoking also damages your airways, leading to inflammation and faster loss of lung function. 

Asthma and Smoking an Unfortunate Combination
Asthma and Smoking: an Unfortunate Combination

Stopping smoking may reduce asthma symptoms and use of asthma medication within a few months.

Tobacco smoke is one of the most common asthma triggers in adults


Smoking and asthma do not combine well. Tobacco smoke harms the airways of both smokers and those who are exposed to environmental tobacco smoke . This can result in:

An increased likelihood of developing asthma and in people who already have asthma, worsening of asthma symptoms and an increase in the number of asthma attacks.

If you already have asthma, smoking increases the risk that you will permanently damage your lungs. You’ll also find that daily control of your asthma can become difficult preventer inhalers are less effective in people who smoke than in non-smokers. Smoking also makes you more prone to chest infections, which are likely to worsen your asthma symptoms.

While the relationship between asthma and smoking can be considered complex  not everyone who is exposed to tobacco smoke will develop asthma the potential of tobacco smoke to provoke asthma or trigger (precipitate or worsen) existing asthma symptoms is well established. Tobacco smoke is one of the most common asthma triggers in adults, and recent evidence suggests that smoking may also be a cause of adult-onset asthma (asthma that starts in adulthood).

Asthma and passive smoking - How can passive smoking affect me if I have asthma?


Breathing in other people’s cigarette smoke can also be harmful to a person with asthma, especially children. Second-hand cigarette smoke can:

Asthma and Smoking: an Unfortunate Combination
Asthma and Smoking

  • Trigger an asthma attack
  • Increase the frequency of asthma attacks
  • Increase your need for asthma medication
  • Make your airways more sensitive to other triggers like pollen
  • Reduce your lung function.
  • Asthma and smoking during pregnancy
If a woman smokes when she is pregnant, the chemicals in the cigarette smoke are passed to the developing baby through the umbilical cord. The baby’s lungs can be affected, which increases the baby’s risk of developing 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.

Asthma and smoking around children


Children exposed to second-hand smoke are more likely to develop asthma in childhood. Children with asthma who live in a smoky environment have more severe symptoms, suffer more frequent asthma attacks and are more likely to use asthma medications. 

Children of people who smoke are 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. Children breathe more rapidly than adults, which means that they will breathe in proportionally more harmful tobacco-smoke chemicals than would an adult who is exposed to the same amount of tobacco smoke.

Parents who smoke increase the likelihood that their children will develop asthma. And children already diagnosed with asthma whose parents smoke are more likely to have severe asthma symptoms compared to children with asthma whose parents do not smoke.

Asthma and Smoking: an Unfortunate Combination


Smoking also produces bronchial inflammation, in this case mediated primarily by macrophages and neutrophils although eosinophil predominance has also been observed in some smokers (an allergic response to certain antigens). The remodeling of the airway wall that accompanies the chronic inflammatory cascade may alter the cell response profile making it difficult to determine which type of inflammatory infiltrate is predominant. The association of asthma and smoking is a reality in our society, and it is a combination that substantially modifies pathogenic mechanisms and gives rise to a more severe clinical picture. Resistance to some of the pharmacotherapies used routinely in the treatment of asthma (corticosteroids) has also been observed and this has favored the use of other drugs (antileukotrienes). One of the preventative measures that should be used more energetically is to encourage patients to stop smoking, paying particular attention to asthmatic smokers.

Asthma and smoking : reducing risk

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

Asthma and Smoking: an Unfortunate Combination

If you do not smoke:


  • Do not allow smoking in your home or in your family car;
  • Ask people not to smoke near your children or near your baby;
  • Direct visitors who want to smoke to the ashtray you have placed outside for their use;
  • Avoid being in smoky environments;
  • Encourage your partner not to smoke, particularly if you are pregnant.

If you are a smoker:


  • Seek advice, support and information about quitting. Quitting smoking is not an easy process, so the more information and support you have the more likely you will be to succeed. Realise that it may take several attempts to quit for the long-term, so keep trying. Try to quit smoking and nicotine replacement therapy cannot be used during pregnancy.
  • In the meantime, smoke outside and not indoors near children or other people, and don’t smoke in the family car.
  • Quit smoking if you are pregnant or, better still, when you are planning a pregnancy and do not smoke near someone who is pregnant, near babies or near children.
If you can’t always keep away from smoky places, it is important to manage your asthma on a daily basis. You should visit your doctor. Your asthma management plan might need to be adjusted. 

What happens if I have asthma and I smoke?


  • Makes your asthma worse;
  • May increase the frequency of asthma attacks;
  • Makes asthma control more difficult;
  • Increases the chances of permanently damaging the airways; and
  • Makes asthma medication less effective.

Smoking during pregnancy: How can smoking during pregnancy affect unborn babies?


Asthma and Smoking: an Unfortunate Combination
Smoking during pregnancy
When a woman smokes during pregnancy she increases the risk that her child will develop asthma (as well as other respiratory illnesses such as coughing and wheezing), and will be more prone to respiratory infection, which is a known trigger for asthma. Smoking during pregnancy is believed to result in these outcomes by affecting the normal development of the baby’s lung tissue while in the womb. 






It causes: 

  • Cause reduced lung growth and function in the unborn baby’s lungs;
  • Increase the chance of the newborn baby developing asthma;
  • Increase the likelihood of an unhealthy birth-weight baby;
  • Increase the risk of SIDS (Sudden Infant Death Syndrome);
  • Increase the risk of a number of health effects.

Smoking around babies and children can:

  • Impair their lung function;
  • Increase their chances of getting asthma;
  • Increase the frequency of their asthma attacks;
  • Increase the severity of their asthma symptoms;
  • Increase their chances of developing respiratory infections.