Everything you need to know about smoking and asthma
Asthma affects over five million people in the UK and an estimated 300 million people globally. Whether you smoke yourself or are breathing in someone else’s smoke, you’re at risk of developing asthma symptoms and having an asthma attack.

This World Asthma Day (3rd May), we’re encouraging people to quit smoking to reduce your asthma risk and to protect your loved ones from the dangers of secondhand smoke.
What is asthma?
Asthma is a chronic long-term lung condition that can be managed but not cured. It affects the airways that carry air in and out of your lungs.
According to Asthma + Lung, there are 5.4 million people in the UK who have asthma – that is one in every 12 adults and one in every 11 children.
It affects people of all ages and often starts in childhood, although some people don’t develop it until they are adults.
What are the symptoms of asthma?
People with asthma often have sensitive, inflamed airways and find that certain things trigger their asthma.
The main symptoms of asthma are:
- a whistling sound when breathing (wheezing)
- feeling breathless
- a tight chest
- coughing
Symptoms can come and go and sometimes people may not have symptoms for weeks or months at a time. They are usually controlled with treatment and most people will have normal, active lives.
However, asthma symptoms can occasionally get worse and cause an asthma attack, which be life-threatening. So, it is important to see your GP or asthma nurse if you notice any of your symptoms getting worse.
What causes asthma?
Asthma affects the airway of your lungs. It causes the airways to narrow and swell, resulting in wheezing and difficulty breathing.
People with asthma have oversensitive airways, which are easily irritated by certain triggers. Most people with asthma are categorised as atopic meaning they have an allergic type of reaction to external triggers such as:
- house dust mites
- pollen
- animal fur
- cigarette smoke
- chest infections
However, for some people the onset of asthma is unpredictable and can be triggered by stress, anxiety and even laughter.
An asthmatic trigger causes the airway walls to swell and the muscles around the airways to contract. The airways narrow and breathing through them produces a whistling sound called wheezing. Mucus is produced from the lining of the airways, which clogs up the narrowed airways further and causes coughing. This makes normal breathing more difficult, producing symptoms of asthma that can be mild, moderate, or severe and life-threatening where hospital treatment is needed.
Most people with asthma can manage it well by using preventative treatment such as an inhaler and trying to avoid their asthma triggers. If your symptoms are getting worse, see your GP or asthma nurse as soon as possible.
How does smoking affect asthma?
If you have asthma and smoke, the best thing you can do is quit as it will reduce the number of frequent asthma attacks and prevent your asthma from getting worse.
Smoking is a trigger for many people living with asthma as it irritates your lungs further and inflames your airways, which can lead to even less air reaching the lungs and increased symptoms.
It doesn’t matter if you smoke cigarettes, cigars, pipes, shisha or roll-ups, smoking increases your risk of asthma symptoms and asthma attacks. Smoking with asthma can also prevent your medication from working correctly, meaning your condition will be harder to control and your symptoms will increase.
In the long-term, smoking cause permanent damage to your lungs and can lead to other respiratory conditions such as COPD (Chronic Obstructive Pulmonary Disease), chronic bronchitis and emphysema.
Can secondhand smoke affect asthma?
Yes. Secondhand snoke is particularly harmful to people who already have asthma. Being exposed to secondhand smoke, will make a person with asthma likely experience the wheezing, coughing and breathlessness associated with asthma.
Secondhand smoke is especially harmful for children as they have less well-developed airways, lungs and immune systems. If a child lives in a household where at least one person smokes they are more likely to develop a range of conditions including: asthma, chest infections, meningitis, ear infections and coughs and colds. Smoking can be a trigger for many children living with asthma, and it can bring on symptoms or even an asthma attack.
What are the benefits of quitting?
One of the best things you can do to improve your asthma is to quit smoking. You will immediately start to lower your asthma risk, no matter how old you are or how long you’ve been smoking.
You will start to notice the benefits within just a few days – as your asthma symptoms should improve as your lungs quickly start to clear out all the toxins.
Quitting smoking will help your lung function improve and hopefully prevent you for developing any other respiratory conditions.
You will:
- breathe more easily as your airways begin to relax
- have fewer symptoms and lower your asthma attack risk
- have more energy as your lung function improves
- have better defences against colds and flu
Need help to quit smoking?
The addictive substance in cigarettes is nicotine. However, nicotine on its own is relatively harmless. The illnesses and diseases caused by smoking come from the thousands of other toxic chemicals in tobacco smoke.
One way of the best ways to stop smoking is by using nicotine that doesn’t come from tobacco. It’s not possible to overdose on nicotine, but it’s possible that you may not use enough when trying to quit which could make you still want to smoke tobacco. That’s why it’s important to use the right level of nicotine for you:
- Nicotine replacement therapy, such as patches, sprays and gum, are safe sources of nicotine and are very effective in helping a smoker to stop as long as the level of nicotine is right.
- Vapingis significantly less harmful than smoking tobacco (e-cigarettes don’t contain tobacco) and have helped many smokers stop smoking tobacco entirely.
- There are also prescribed medicationsthat can break the addiction to nicotine in the brain.
The best chance of stopping successfully is with a combination of personalised support and a stop smoking aid – like nicotine replacement, e-cigarettes, or medication.
For help to stop smoking, speak to your Local Stop Smoking Service, GP or pharmacist, or call the NHS Stop Smoking helpline free on 0300 123 1044. Greater Manchester residents can also get six months’ free access to the Smoke Free app – usually worth £60 – by signing up online at www.smokefreeapp.com/GM (T&Cs apply).
Content in this article has been reviewed by Dr Tom Pantin, Respiratory Consultant and Clinical Lead for Severe Asthma at Wythenshawe Hospital.