Asthma and Smoking

We all know that cigarette smoking is bad for your health and damages your lungs. Studies have also shown that smoking can make your asthma worse. In short: asthma and smoking are not a good combination.

Smoking damages the lungs so it is especially risky to smoke if you have asthma. There are more than 7,000 chemicals in tobacco smoke and at least 250 are known to be harmful. When you inhale cigarette smoke, these harmful substances irritate and damage your airways, making you more prone to an asthma flare-up.

How Does Smoking Trigger Asthma Symptoms?

There is no evidence to suggest that smoking directly causes asthma. However, we know that smoking makes asthma worse. Here are some of the ways it can aggravate asthma:

  • Smoking triggers mucus production in the lungs, which leads to coughing.
  • The chemicals in tobacco smoke damage lung tissue.
  • Particles in tobacco smoke irritate and settle in the lining of the airways, causing them to swell and become narrow. This leads to wheeziness and chest tightness.
  • Tobacco smoke damages tiny hair-like structures in the airways called cilia, which sweep dust and mucus out of the airways. This means dust and mucus accumulate in airways, aggravating your asthma.
  • Lung damage caused by smoking makes your asthma less responsive to medication.
cigarette smoke

Asthma and Vaping

Some smokers have turned to e-cigarettes to help them quit. There is now a growing body of research suggesting that using e-cigarettes (known as vaping) is also harmful to lung health.

E-cigarettes use a battery-powered device to heat a solution containing nicotine, flavorings, and other substances you inhale as a vapor or aerosol rather than smoke.They are considered less harmful than smoking cigarettes because they do not contain the hundreds of harmful chemicals found in cigarette smoke.

However, vaping is a relatively new technology and scientists are still researching how safe it is to our health. More studies are beginning to show that vaping can increase inflammation in the airways and cause breathing difficulties which can intensify asthma
symptoms and trigger asthma attacks.

A University of California study found that vaping increased the risk of chronic lung disease, including asthma. According to the research, [1] e-cigarette users were about 30% more likely to develop a chronic lung disease while tobacco smokers increased their risk by 160%. Other US research [2] has found that high school students who vaped had a higher risk of asthma attacks and were more likely to miss school due to severe asthma symptoms.

While there is no conclusive evidence that either smoking or vaping directly causes asthma, it appears they can both make your asthma worse, increasing your risk of more severe attacks and resulting in poorer control of the condition.

How Does Vaping Trigger Asthma Symptoms?

Vaping can trigger asthma symptoms in the following ways:

  • The main chemicals in e-cigarettes, such as propylene glycol and vegetable glycerine, have been linked to increased cough, mucus secretions, chest tightness, and reduced lung function, all of which can make asthma worse.
  • Vaping can irritate the lung’s airways, making asthma attacks more likely.
  • Research [3] has linked some flavored additives in e-cigarettes to causing cell damage in the airways, which worsens asthma.
  • One comprehensive study [4] of more than 19,000 e-cigarette users found common side effects included coughing and a dry throat, which could make asthma worse.
  • Vaping may help pneumonia-causing bacteria to stick to cells that line the airways, causing further damage to the lungs. People with asthma might be vulnerable to this.
  • Vaping might impair the lung’s ability to fight infection, increasing the risk of more severe asthma attacks.
Vaping

Secondhand Smoking and Vaping

Does secondhand vaping affect asthma?

Even if you do not smoke, being exposed to second-hand smoke can make your asthma worse. Second-hand smoke is a mixture of smoke given off by a smoldering cigarette and smoke exhaled by the smoker. Breathing this in will irritate your lungs, leading to coughing, excess mucus, chest discomfort, and risk of an asthma attack. There is no risk-free level of exposure to secondhand smoke and even a minor exposure can be harmful to respiratory health.

You can avoid secondhand smoke by:

  • Not allowing people to smoke in your house or car – politely ask them to step outside.
  • Politely ask people not to smoke around you. If necessary, explain that you have asthma and being exposed to cigarette smoke makes your symptoms worse.

Does smoking harm my child?

Children who live with a smoker and breathe in second-hand smoke are more likely to develop asthma and have more frequent and severe attacks. This is because children’s lungs have not finished growing and they have less developed airways, lungs and immune systems. Being exposed to second-hand smoke can irritate a child’s lungs, making them produce more mucus and be more prone to infections which make asthma symptoms worse.

A study [5] from the University of Cincinnati also found that non-smoking adolescents who lived with a smoker were more likely to be short of breath. They were also more prone to wheezing during or after exercise and have a cough at night.

Can smoking harm my unborn child?

There is a wealth of evidence [6] to show that smoking during pregnancy is harmful to the mother’s unborn child. When a mother smokes, she exposes her unborn baby to the harmful chemicals in cigarette smoke via her bloodstream.

Children who are born to mothers who smoked when pregnant have poor or delayed lung function and a significantly higher risk of developing asthma. Research also shows that smoking while pregnant increases the risk of premature birth and low birth weight.

Does second-hand smoking affect asthma?

Secondhand vaping – breathing in the vapor of someone using e-cigarettes – can also have harmful effects for people with asthma.


A study published in 2019, for example, found that teenagers with asthma who were exposed to second-hand e-cigarette vapor were 27% more likely to report having had an asthma attack in the previous year, compared with those who were not exposed. [2]

Help to quit smoking and vaping

If you have asthma, quitting smoking can make a significantly positive impact on your symptoms and general health. Due to the addictive nature of nicotine found in tobacco and vaping products, it can be difficult to quit without support.

Tips for cutting out cigarettes and e-cigarettes:

  • Ask your doctor to refer you to your local stop smoking service for advice and support on quitting smoking.
  • Try nicotine replacement aids to help you control cravings: these include patches, gum, lozenges and mouth and nasal sprays.
  • Try online services or apps to help keep you motivated and learn ways to control your addiction.
  • Your doctor may be able to prescribe stop-smoking medicines to help you manage your cravings.
  • If you habitually smoked after eating or when having a drink, change your routine after these situations.
  • Make a list of the reasons you are quitting and refer to this when you get cravings.
  • Tell your family and friends you are quitting for their support.
  • Remove all cigarettes, e-cigarettes and smoking products from your home, bag and car.
  • Make a plan to quit – set a date and stick to it.

Citations

  1. Bhatta DN, Glantz SA. Association of E-Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis. American Journal of Preventive Medicine. 2019;58(2).doi:https://doi.org/10.1016/j.amepre.2019.07.028
  2. Bayly JE, Bernat D, Porter L, Choi K. Secondhand Exposure to Aerosols From
    Electronic Nicotine Delivery Systems and Asthma Exacerbations Among Youth With
    Asthma. CHEST. 2019;155(1):88-93. doi:https://doi.org/10.1016/j.chest.2018.10.005
  3. Chapman, D.G., Casey, D.T., Ather, J.L. et al. The Effect of Flavored E-cigarettes on
    Murine Allergic Airways Disease. Sci Rep 9, 13671 (2019).
    https://doi.org/10.1038/s41598-019-50223-y
  4. Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A
    Worldwide Survey of More than 19,000 Consumers by Konstantinos E. Farsalinos
    1,*,Giorgio Romagna 2,Dimitris Tsiapras 1,Stamatis Kyrzopoulos Int. J. Environ. Res.
    Public Health 2014, 11(4), 4356-4373; https://doi.org/10.3390/ijerph110404356
  5. Exposure to tobacco smoke significantly impacts teen health: Secondhand smoke linked
    to poor health, higher absenteeism, increased likelihood to seek medical attention.
    ScienceDaily. https://www.sciencedaily.com/releases/2018/08/180821185231.htm
  6. Zacharasiewicz A. Maternal smoking in pregnancy and its influence on childhood
    asthma. ERJ Open Res. 2016 Jul 29;2(3):00042-2016. doi: 10.1183/23120541.00042-PMID: 27730206; PMCID: PMC5034599.