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Asthma and Smoking: How To Prevent

What Is Asthma?

Asthma is a chronic lung disease that causes episodes of difficulty in breathing. Asthma symptoms are caused primarily by chronic inflammation of the airways. This makes the airways of the patient with asthma highly sensitive to various trigger factors.

When the airways inflammation is triggered by any type of external or internal trigger factors, the airways swell and fill with mucus. Muscles within the airways will contract which can lead to further narrowing of the airways. The airways narrowing makes it difficult for the air to be breathed in and out from the lungs and it lead to various symptoms of asthma.

How is tobacco smoke related to asthma?

Tobacco smoke including secondhand smoke is one of the most powerful trigger of asthma symptoms. In fact, exposing to secondhand smoke/ passive smoke/ environmental tobacco smoke, can be more harmful than actually smoking.

How can tobacco smoke be avoided?

Patients with asthma should be advised about the dangers of smoking to themselves and their children with asthma and appropriate support to stop smoking should be offered.

Patients can reduce the risk of worsening of their asthma by avoiding exposure to tobacco smoke. Some suggestions include:

  • Quit smoking if you are smoker. Quitting smoking is a difficult process but there are many quit smoking programs and methods to help.
  • If your spouse or other family members smoke, help them to understand the dangers of smoking and encourage them to stop.
  • Make your house completely smoke free by requesting guests not to smoke in the house.
  • Do not smoke or allow others to smoke in your car and opening the windows do not protect you from the harm of tobacco smoke.
  • Avoid public places such as pubs, bars, cafes and restaurants that allow smoking.
  • Do not allow anyone smoke near you, your spouse or your children.
  • Make sure your children’s day care centers and schools are free of tobacco smoke.
  • Teach your children to stay away from secondhand smoke and be a good role model by not smoking.

What should be done when you can not avoid smoky places?

  • You might need to adjust your asthma management plan and might need to use more preventer and reliever medication.
  • Remember to bring along your reliever medication with you whenever you visit a smoky place.

If I quit smoking, what benefit will I get?

  • Quitting smoking decreases the chance of triggering asthma attacks, thus, may reduce asthma symptoms and the frequent use of asthma reliever medication.
  • Improves your lung function whether you have asthma or not. The damage to the airways by tobacco smoke usually cannot be reversed but it is never too late to stop smoking.
  • Within a few minutes of quitting, your body will feel a series of benefit such as having more energy, breathing easier, smelling and tasting food better.
  • Long-term benefits of quitting smoking include: decreasing the risk of heart attack and stroke, improving blood circulation, decreasing sinus congestion and cough.

How is the asthma symptom when patients first give up smoking?

Asthma symptoms may sometimes get worse when patients first give up smoking. This is because the lungs have started to work properly after quitting and clearing out the dust or smoke from the airways.

These changes can further irritate the airways, causes more cough and make the asthma worse for a short period of time. What need to be done include:

  • If the asthma symptoms have got worse after quitting, make an appointment with your doctor to have your symptoms and asthma treatments reviewed.
  • Sometimes you may need to take a short course of oral steroids or other asthma treatments to get your asthma symptoms under control.

This should get better after a short while and then you will start to feel the real improvements in your asthma control and general well-being from giving up smoking.

Facts about quitting

  • Most people know about the dangers of smoking but it is always not easy for people to quit smoking because nicotine is a very addictive drug.
  • However, it is not impossible to quit and many people manage to stop smoking with or without much help.
  • Understand that those who do try to quit are very likely to make several quit attempts to stop before they stop successfully.
  • Consider what you have done before but fail and what you can do now to make the next quit attempt successful.

How to give up smoking habit?

Stopping smoking, especially if you or your family members have asthma, is one of the best ways you should do to avoid asthma attack and to improve their overall health and well-being.

Four steps to giving up smoking are:

  1. Understand your smoking habit
    • Keep a diary of when, where and why you smoke.
    • By knowing the situations that make you want to smoke will help you plan how you can avoid the situations.
  2. Know why you want to stop
    • Make a list of all the reasons why you want to stop smoking.
    • When you have written the list, keep it with you to remind you what the benefits of stopping.
    • Look at the list every time you are tempted to smoke again.
  3. Make use of the smoking cessation services available
    • These services are provided by private and public health care facilities and they can support and advise you about quitting.
    • You are more likely to quit successfully and stay away from smoking if you have good support.
  4. Set a date and stick to it
    • After smoked your last cigarette, throw away lighters, ashtrays and all cigarettes.
    • Start thinking of yourself as a non-smoker and stay determined with your quit attempt.

(Refer to Tak Nak portal on non-pharmacology and pharmacological treatment for smoking cessation)

In summary

Tobacco smoke is a powerful asthma trigger that can worsen asthma symptoms. People who smoke and who have asthma will have worse asthma control, more airway damage and faster loss of lung function. Second-hand smoke or passive smoke is also a trigger for people with asthma. Therefore, it is important for asthma patient to quit smoking or to avoid exposure to secondhand smoke to prevent further attack of severe asthma.


  1. Centers for Disease Control and Prevention. Asthma: Common Asthma Triggers [last updated 2012 Aug 20; accessed 2014 August 28].
  2. Centers for Disease Control and Prevention. Secondhand smoke and asthma. [accessed 2014 August 28].
  3. Asthma Foundation. Smoking and asthma. [accessed 2014 August 28]
  4. American Academy of Allergy, Asthma & Immunology: No Butts About It: Smoking Makes Asthma Worse. Updated May 15, 2013 Worse.” [accessed 2014 August 28]
  5. Asthma UK. Smoking with asthma. [accessed 2014 August 28]
  6. Ministry Of Health Malaysia. Clinical Practice Guidelines For Management Of Adult Asthma 2002.
  7. Global Strategy for Asthma Management and Prevention: Global Initiative for Asthma (GINA) (Updated 2014)
  8. British Thoracic Society. British Guideline on the Management of Asthma-a national guideline 2008.
Last Reviewed : 6 March 2016
Writer : Dr. Ho Bee Kiau
Accreditor : Dr. Norhaya bt. Mohd Razali

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