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Questions and Answers About Smoking and Asthma

Tobacco smoke is an exceptionally aggravating trigger that can worsen asthma symptoms for the nearly 20.3 million people in the United States who suffer from asthma. Quitting smoking should be a priority for people who have asthma, or have family members with asthma, according to the American Academy of Allergy, Asthma and Immunology (AAAAI).

For people suffering with asthma, smoking is the worst thing you can do. Below, Linda Ford, MD, FAAAAI, AE-C, of the AAAAI's Quality of Care for Asthma Committee, answers common questions about smoking and its effects on asthma. Dr. Linda Ford is an allergist/immunologist in Papillion, Nebraska and a former president of the American Lung Association.

Q: What is asthma?
A: Asthma is a chronic inflammatory lung disease that blocks air flow of the tubes (airways) that leads air to the lungs. By squeezing the muscles around the airways and causing swelling, inflammation of the inside of the air tubes, and producing excess mucus, the airways become narrower and therefore more difficult for air to move in and out of the lungs.

Q: How does smoking affect a person's asthma?
A: Smoking can harm your body in many ways, but it is very harmful to the lungs. The airways in a person with asthma are very sensitive and "twitchy" and therefore can easily be squeezed down by the smooth muscle that surrounds these tubes. Many things can trigger symptoms such as coughing, wheezing, experiencing chest tightness and shortness of breath. When a person inhales tobacco smoke whether for personal smoking or passive smoke, these irritating substances can set off an asthma attack.

Q: How does smoking affect pregnancy?
A: Children born to mothers who smoke when pregnant have an increased risk for reduced lung function and asthma. Other risks include decreased birth weight and size as well as an increased risk for eczema and hay fever. Once you quit smoking, your baby will be healthier, get more oxygen and have fewer infections and colds. It is also important to stay away from places that allow smoking when you are pregnant, since secondhand smoke can contribute to these risks.

Q: What is the danger of secondhand smoke exposure?
A: Children are more susceptible than adults to the effects of secondhand smoke because their lungs are still developing. After infancy, exposure to tobacco smoke may continue to cause abnormal breathing. Smoking leads to decreased lung function, making the lungs more susceptible to asthma triggers. Fifteen million children are regularly exposed to secondhand smoke and up to one million children with asthma become more severe after exposure to secondhand smoke. Children who inhale environmental tobacco smoke are also at increased risk for a variety of problems including cough, wheeze, ear infections, bronchitis, pneumonia, allergic diseases, and hospital admissions for asthma.

Q: What changes will I see if I quit smoking?
A: Quitting smoking decreases the chance of triggering asthma attacks and improves your lung function whether you have asthma or not. Everyone should be smoke free. While you are stopping, at least you can stop smoking in the house and the car to decrease exposure to secondhand smoke for your family members. Within minutes of quitting smoking, you will begin a series of changes in your body such as having more energy, breathing easier, smelling, tasting food better, and decreasing your body's carbon monoxide level. Some long-term benefits of quitting smoking are the decreasing chance of heart attack, improving your circulation, decreasing sinus congestion and cough, and reducing the risk of a stroke.

The AAAAI and the Environmental Protection Agency (EPA) have worked together to increase awareness about the dangers of secondhand smoke through the Smoke Free Home Campaign. Visit the Patient and Consumer resource page on the AAAAI Web site, www.aaaai.org, to learn more about the campaign and to take the pledge for a smoke free home.

Q: How can my allergist/immunologist help me manage my asthma?
A: An allergist/immunologist is a physician specially trained to manage and treat allergies and asthma. To help prevent symptoms, he or she will work with you to figure out your asthma triggers and develop an appropriate management plan, including developing environmental controls and prescribing medication if needed.

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