It may not surprise you to learn that smoking and secondhand smoke are two of the leading causes of asthma symptoms. But that doesn't mean that adults with asthma don't smoke. In fact, about 17% of adults with asthma use tobacco products even though it may cause them to experience severe wheezing and shortness of breath. Unfortunately, smoking is highly addictive so even though quitting is the single best thing someone can do to help their asthma symptoms, it can still be very hard to quit.

"Many people with milder forms of asthma start smoking at a younger age, when symptoms aren't as prominent. But as they continue to smoke, it causes increased inflammation which in turn worsens their symptoms. Unfortunately, by then they are addicted to the nicotine and have a hard time quitting, so it becomes a vicious cycle," the American Lung Association's Chief Medical Officer Dr. Albert Rizzo, explained.

What Exactly Are You Inhaling? 

When tobacco is burned, it releases more than 7,000 chemicals, including known toxins and carcinogens such as formaldehyde, benzene, vinyl, chloride, arsenic, ammonia and hydrogen cyanide. At least 69 of these chemicals are known to cause cancer and many are toxic. Even those who don't smoke are at risk of inhaling these toxins when they are around tobacco users, since the same chemicals are found in secondhand smoke.

The most recent threat to lung health is e-cigarettes. Also known as vapes, JUULs, e-pens, e-pipes, e-hookah, and e-cigars, the main component of all e-cigarettes is the e-liquid which gets heated up and inhaled through aerosol. To create these e-liquid cartridges, nicotine is extracted from tobacco and mixed with a base, such as propylene glycol, and chemicals like formaldehyde and acrolein, as well as flavoring and coloring to add appeal.

How Smoking Is Affecting Your Lung 

As a person living with asthma, it is especially important to quit smoking and avoid secondhand smoke. Tobacco smoke causes irritation to the lungs which includes redness, swelling and excess mucus production. Asthma patients already struggle to maintain a clear airway, so smoking is particularly troublesome for them because it causes asthma symptoms to occur. "When a patient already has inflammation, the last thing they want to do is inhale secondhand smoke or e-cigarette product aerosol which adds to that irritation and makes their asthma harder to control," said Dr. Rizzo.  Asthma patients experiencing a flare up may experience coughing, shortness of breath and trouble breathing, wheezing, or chest tightness.

Aside from causing inflammation which may trigger an asthma flare up, tobacco product smoke destroys lung tissue and breaks down our lungs' natural defenses to clear out dirt and germs. "The constant irritation from the tobacco smoke changes the cell types in the airways and can lead to the development of another chronic lung condition, COPD or emphysema," Dr. Rizzo warned. "When a patient struggles with both asthma and COPD the airways can cause persistent airflow limitation causing them to receive a more specialized treatment."

Though there is much left to be determined regarding the long-term impact e-cigarette products have on lungs, some recent studies have reported that the inhalation of harmful chemicals found in the cartridges such as formaldehyde and acrolein, can cause irreversible lung damage. These toxins can similarly cause an asthma patient's airways to swell, making it more difficult to breathe.

To learn more about the health effects of smoking, secondhand smoke and vaping on lung health visit

Five Things You Can Do to Help Control Your Asthma

  1. The best thing you can do for your asthma and overall health is to quit smoking.
  2. Talk to family and friends about your asthma and how secondhand smoke affects you. Ask them to not smoke or vape around you.
  3. Have good communication and visit your healthcare provider at least once a year to monitor your asthma, check your treatment plan, observe your medication inhalation technique, and update your asthma action plan.
  4. Learn more about how to recognize your asthma symptoms, triggers, and self-management practices by completing the Lung Association's Asthma Basics course, available in both English and Spanish.
  5. For additional tips to better control your asthma, visit

Need Help Quitting?

If you are an asthma patient and you want to quit smoking, the American Lung Association is here to offer support. The Lung Association believes everyone who uses tobacco products can quit using methods that are proven safe and effective by the FDA, including the seven FDA-approved medications and individual, phone and group counseling (such as the Lung Association's Freedom from Smoking® program). To learn more about our available programs, visit or call 1-800-LUNGUSA.

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