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Tobacco smoke hurts everyone. It can affect you even if you aren’t around someone who is actively smoking. Studies now show that tobacco’s effects reach much farther than its smoke does.

Tobacco smoke can do a lot of damage to your health. But did you know it can be even more harmful to those who have asthma, especially sensitive groups like children and older adults?

How Does Tobacco Smoke Affect Asthma?

Asthma is a chronic disease that causes your airways to become inflamed, making it hard to breathe. Asthma triggers cause this inflammation. Triggers are things that bother people with asthma but may not bother other people. Tobacco smoke is one the most common triggers of asthma symptoms.

Symptoms of asthma include:

  • Coughing
  • Wheezing (a whistling, squeaky sound when you breathe)
  • Shortness of breath
  • Rapid breathing
  • Chest tightness

When you think of the bad ingredients in tobacco, nicotine usually comes to mind. But tobacco smoke is full of many other toxic substances, like arsenic and cyanide.

In fact, tobacco smoke has more than 7,000 toxic chemicals. About 70 of them are known to cause cancer.1 With this in mind, it’s no surprise tobacco is one of the most common asthma triggers.

What Is Secondhand Smoke?

Secondhand smoke is tobacco smoke inhaled by someone who doesn’t smoke. It can cause many of the same problems smoking can cause. Children are the most affected by secondhand smoke.

Secondhand smoke can cause serious health problems in children.

  • Babies exposed to tobacco smoke before birth or during the first few months are more likely to have asthma and allergies.2
  • Studies show that older children whose parents smoke get sick more often. Their lungs grow less than children who do not breathe secondhand smoke. They also get more bronchitis and pneumonia.
  • Wheezing and coughing are more common in children who breathe secondhand smoke.
  • Secondhand smoke can trigger an asthma attack in a child. Children with asthma who are around secondhand smoke have worse and frequent asthma attacks.
  • More than 40 percent of children who go to the emergency room for asthma live with smokers.
  • Children whose parents smoke around them get more ear infections. They have fluid in their ears more often. They also have more operations to put in ear tubes for drainage.


AAFA supports the #BeTheFirst campaign by CVS Health. By reducing exposure to tobacco smoke, we can decrease the number of emergency room visits, asthma attacks and illnesses in children with asthma. Visit for more information.

What Is Thirdhand Smoke?

Not many people know about thirdhand smoke. Studies show thirdhand smoke can affect asthma and cause other health problems as much as smoking and secondhand smoke does.

Thirdhand smoke is residue from tobacco smoke. It sticks to surfaces and dust for months after a cigarette has been smoked. Then it reacts to other pollutants in the air, like ozone, to create harmful particles you can easily inhale.3 These particles are extremely tiny. This means it’s easier for them to get into your lungs. Some experts believe they may be worse for those with asthma than nicotine.

Smoking outdoors does not reduce the threat of thirdhand smoke. Airing out rooms or cars doesn’t help either. The residue still sticks to your skin and clothing. People (including children) then breathe in the residue or absorb it through their skin or mouth. It is important to know that thirdhand smoke cannot be avoided by opening windows, using fans or air filters or confining smoking to certain rooms or outside.

Cotinine, a chemical found in tobacco, can be found in the urine of those who come in contact with thirdhand smoke. Cotinine is how doctors can measure nicotine in the bloodstream. This shows that the effects of tobacco can go far beyond its smoke.

The only way to protect nonsmokers from the effects of tobacco is to create a completely tobacco-free environment.


How Can I Reduce Exposure to Tobacco Smoke?

The only way we can decrease asthma rates from tobacco is to reduce exposure to it. Here are some steps you can take to reduce asthma symptoms from tobacco smoke:

  1. If you smoke, do your best to quit. There are many resources and groups available to help you. Two common resources are 1-800-QUIT-NOW and
  2. Talk to your children about the dangers of smoking and how it affects asthma.
  3. Ask others to not smoke in or near your home.
  4. Visit smoke-free homes and businesses with a no-smoking policy.
  5. Choose childcare that will not expose your child to second- and thirdhand smoke. Even if a caregiver doesn’t smoke around a child, they can still expose a child to thirdhand smoke on their clothes or skin.

Around 25 million people have asthma and the numbers keep increasing. If we all work together to deliver the first tobacco-free generation, we can help reduce asthma rates overall.

CVS Health is a sponsor of this blog post to help us share information about the harmful effects of tobacco smoke on people with asthma.

Medical Review August 2017.

It is important to stay up-to-date on news about asthma and allergies. By joining our community and following our blog, you will receive news about research and treatments. Our community also provides an opportunity to connect with other patients who manage these conditions for support.


1. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General.Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014

2. Raherison, C., Pénard-Morand, C., Moreau, D., Caillaud, D., Charpin, D., Kopfersmitt, C., . . . Annesi-maesano, I. (2007, January). In utero and childhood exposure to parental tobacco smoke, and allergies in schoolchildren. Retrieved August 10, 2017, from

3. Matt, G. E., Quintana, P. J. E., Destaillats, H., Gundel, L. A., Sleiman, M., Singer, B. C., … Hovell, M. F. (2011). Thirdhand Tobacco Smoke: Emerging Evidence and Arguments for a Multidisciplinary Research Agenda. Environmental Health Perspectives, 119(9), 1218–1226.


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