Smoking and Asthma

By Chris Woolston
CONSUMER HEALTH INTERACTIVE

Topics:

Setting the stage for an asthma attack
Secondhand danger

Shortly after blood-sucking leeches went out of style, 19th-century doctors embraced an equally bizarre remedy for some ailments: cigarettes and pipes packed with tobacco. Amazingly, doctors often prescribed this "cure" to patients with asthma. According to the strange logic of old-time medicine, patients could breathe easier if they got enough healing smoke in their lungs.

Setting the stage for an asthma attack

Today, doctors know that in some cases leeches may actually help wounds heal. But they've also learned that treating asthma with cigarettes is as wise as prescribing whiskey for alcoholism. Lighting up is just about the last thing a person with asthma should do. Tobacco smoke, including secondhand smoke, damages the cells that make the protective coating of mucus lining the bronchial tubes. Without their first line of defense, the tubes become irritated and inflamed, setting the stage for an asthma attack. Smoke also makes the airways slow to heal.

In short, smokers with asthma can't take breathing for granted. They often need extra medications just to keep their airways open, and they still suffer more than their share of attacks. As long as they keep smoking, they'll find it hard to bring their asthma under control.

If you're a smoker and have decided to stop smoking: congratulations. Talk to your doctor if you're having trouble quitting. [See How to Stop Smoking for a wealth of tips.] Quitting is often extremely tough, but you don't have to do it alone. Old-fashioned determination -- coupled with the help of a nicotine replacement product, a prescription drug that eases cravings, a support group, or some combination of the three -- should enable you to overcome the addictive pull of nicotine. You can also protect your airways by staying out of any bars and restaurants that have a thick haze in the air.

Secondhand danger

Tobacco smoke is even more hazardous when it reaches children's lungs. Children with asthma who live in smoke-filled homes have more wheezing fits, need more medications, and make more trips to the emergency room than other asthma patients their age.

When kids don't already have asthma, secondhand smoke can usher them into the club. The disease is 20 to 30 percent more common in children whose parents smoke. And the more smoke, the greater the risk. A study published in the American Journal of Epidemiology found that children were almost four times as likely to develop asthma if their mothers smoked more than 20 cigarettes a day. Simply put: If more parents could live without cigarettes, more children could live without inhalers.

And that's not the only reason to quit. Children exposed to secondhand smoke are more likely to develop bronchitis and pneumonia, and some of them become so sick they have to be hospitalized.

Ideally, pregnant women who smoke should quit as soon as possible and avoid secondhand exposure. Tobacco chemicals in the womb are even more dangerous than smoke wafting through the house. The effects of tobacco chemicals in the mother's bloodstream can weaken a fetus's developing lungs, and infants born to smoking mothers may not be able to breathe as easily as other infants. The lungs may recover within a few years -- especially if the parents give up smoking. But it's better not to take that chance. In addition, smoking during pregnancy also raises the risk that your baby will be born too soon or underweight.

The bottom line: nobody should smoke around young children, especially children who already have asthma. If there's a little set of lungs in your house, take your cigarettes outside, or better yet, get rid of them. Quitting smoking is hard. For kids, breathing shouldn't have to be.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.

Further Resources

American Academy of Allergy, Asthma, and Immunology
800-822-ASMA
http://www.aaaai.org

American College of Allergy, Asthma, and Immunology
800-842-7777
http://www.acaai.org/

American Lung Association
800-LUNG USA
http://www.lungusa.org

Asthma and Allergy Foundation of America
800-7-ASTHMA
http://www.aafa.org

References

Strachan DP, Cook DG. Health effects of passive smoking. 6. Parental smoking and childhood asthma: longitudinal and case-control studies. Thorax. 1998 Mar;53(3):204-12.

Infante-Rivard, Claire. Maternal smoking and childhood asthma. American Journal of Epidemiology. 1999 Sept. 1;150(5);528-31.

Floreani, Anthony. The role of cigarette smoke in the pathogenesis of asthma and as a trigger for acute symptoms. Current Opinion in Pulmonary Medicine. 1999; 5:38-46.

Peat, JK. Current reviews of allergy and clinical immunology. The Journal of Allergy and Clinical Immunology. 1998; Volume 103, Number 1, Part 1: 1-9 pp.

Dezateux C et al. Airway function at one year: association with premorbid airway function, wheezing, and maternal smoking. Thorax 2001 Sep;56(9):680-6

Joad JP. Smoking and pediatric respiratory health. Clin Chest Med 2000 Mar;21(1):37-46, vii-viii

Reviewed by Martha Vetter White, M.D., director of research at the Institute for Asthma and Allergy in Washington, D.C.

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