Smoking is unhealthy for everyone, but especially for someone with asthma. The lungs of a smoker, with or without asthma, may not work as well as they should. The person might cough, wheeze, and have shortness of breath. Smoking causes the airways to 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.

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 damage the lungs, leading to long-term breathing problems or worsening existing breathing problems.

Kids with asthma who live in households with smokers:

• may have flare-ups more often
• are more likely to have to go the emergency department 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 medication

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. Just 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.

And here's the best reason of all to quit smoking: Children whose parents smoke are more likely to smoke themselves when they get older.

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

Exposure to Smoke Outside the Home

Even if no one in your household smokes, kids will still encounter secondhand smoke. 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 adequate 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.

Sending an Antismoking Message

No one wants their child to start smoking, but it's especially important to discourage this behavior in kids who have asthma. If your child has asthma, smoking may actually undo the effect of any controller medication. Your child also may need to use rescue medications more often, visit the doctor or the emergency department more often, and miss school more often because of flare-ups.

Kids with asthma who smoke may sleep less at night and be less able to participate in sports or other physical activities. And of course, there are the long-term health consequences, such as heart disease, emphysema, and cancer.

Give your child tips on how to say no if offered a cigarette. To lay the groundwork for that moment:

• Teach your child 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 child he or she isn't allowed to smoke.

If your child already smokes, you're not alone. Almost 1.5 million 11- to 17-year-olds start smoking each year. Nearly half of them will become regular smokers. In fact, 90% of smokers start before they're 21.

Still, despite the obvious risks, your child may not respond to an antismoking message. Though the long-term consequences are clear, preteens and teens often feel invincible.

Instead, discuss the immediate consequences: Smoking will cause more asthma flare-ups and make asthma more difficult 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.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date reviewed: October 2010