Smoking and Asthma

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. 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.

References

Centers for Disease Control and Prevention, Asthma and Secondhand Smoke, https://www.cdc.gov/tobacco/campaign/tips/diseases/secondhand-smoke-asthma.html

Smoking and Asthma, The Cleveland Clinic http://my.clevelandclinic.org/disorders/asthma/hic_smoking_and_asthma.aspx

Secondhand Smoke, Environmental Protection Agency http://www.epa.gov/asthma/shs.html

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

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

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

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