How Can Smoking Affect Someone With Asthma?

Smoking cigarettes is an unhealthy habit for anyone, but it's especially bad for people who have asthma. Smoking makes the airways become swollen, narrow, and filled with sticky mucus — the same problems that cause breathing trouble in people with asthma. For this reason, a smoker who has asthma is more likely to have more frequent and severe flare-ups.

Vaping (using e-cigarettes) also can irritate or damage the airways, making asthma flare-ups more likely. Experts are still studying the effects of vaping on asthma in children and teens.

Being a smoker is an obvious risk, but just being around people who smoke — and breathing in secondhand smoke — can cause problems, too. Parents can help kids and teens with asthma by protecting them from the effects of tobacco smoke.

The Dangers of Secondhand Smoke

Secondhand smoke is a well-known asthma trigger. If you smoke, consider quitting, especially if your child has asthma. Secondhand smoke can harm the lungs, cause long-term breathing problems, and make existing breathing problems worse. 

Kids with asthma who live in households with smokers:

• may have flare-ups more often
• are more likely to have to go the ER with severe asthma flare-ups
• are more likely to miss school because of their asthma
• must take more asthma medicine
• have asthma that's harder to control, even with medicine

Even kids who don't have asthma are at risk of problems if their parents smoke. These kids are more likely to get upper respiratory infections, middle ear infections, and even pneumonia. Being exposed to smoke from 10 cigarettes per day may put kids at risk of developing asthma, even if they've never had any breathing problems before.

Cigarette smoke can also get absorbed into upholstery, clothing, and carpeting, leaving carcinogens that can't be washed away with soap and water. Kids who touch, mouth, play on, or breathe near contaminated surfaces may develop breathing problems from this kind of "thirdhand" smoke.

And here's another great reason to quit smoking: Children whose parents smoke are more likely to smoke when they get older.

You don't have to quit on your own. Talk to your doctor about possible strategies — from support groups to medicine. If you do keep smoking, don't smoke in the house or car.

Protecting Kids From Smoke Outside the Home

Even if no one in your household smokes, kids will still be around secondhand smoke at times. Try to help them avoid it as much as possible.

If your child has asthma, let friends, relatives, and caregivers know that tobacco smoke may cause an asthma flare-up. To protect your child from having to breathe in smoke:

• Don't allow guests to smoke in your house or car.
• Avoid smoky restaurants and parties. Choosing the nonsmoking section is not enough protection.
• Ask friends and relatives not to smoke around your child.
• Choose caregivers who don't smoke or, if they do, ask them not to smoke around your child.
• Encourage family members who smoke to quit.

How Can Parents Help?

No one wants their child to start smoking, but it's especially important to discourage this bad habit in kids who have asthma. Smoking may actually undo the effect of medicines they take to keep their asthma under control. They also may need to use medicine more often for quick relief of symptoms, visit the doctor or the ER more often, and miss school because of flare-ups.

Smoking also can cause sleeping problems and make it hard for kids to do sports or other physical activities. And of course, there are the long-term health consequences, such as heart disease, lung disease, and cancer.

Encourage your kids to say no if offered a cigarette. To help prepare them for that moment:

• Teach them the facts about smoking and the short- and long-term damage it can do.
• Talk about how expensive cigarettes and other tobacco products are.
• Discuss how smoking gives people bad breath, smelly clothes, and yellow teeth.
• Tell your kids they do not have your permission to smoke and, if they start, they're not allowed to do it in your house or anywhere around your family.

If your child already smokes, you're not alone. In 2023, about 430,000 U.S. middle school and high school students reported that they'd smoked cigarettes in the past month. Nearly half of kids who smoke will become regular smokers, and almost all smokers started their habit before age 21.

Despite the risks, kids may not respond to an antismoking message because preteens and teens often feel invincible. Instead, talk about the immediate effects: Smoking will cause more asthma flare-ups and make asthma harder to control. When asthma isn't controlled, it gets in the way of what kids want to do, such as playing sports or going out with friends.