Asthma and Passive Smoking

Smoking is a well-known health hazard. But did you know that even if you’re not the one lighting up, you can still be at risk? Passive smoking, also known as second-hand smoke, affects not only non-smokers but especially individuals living with asthma.

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What Is Passive Smoking?

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Passive smoking occurs when a non-smoker involuntarily breathes in the smoke exhaled by smokers or the smoke emitted from burning tobacco products1. It’s important to note that passive smoking is not limited to just the visible smoke from a cigarette; it includes the invisible toxins released into the air as well. Passive smoke exposure can happen in various settings, such as homes, cars, public places, and workplaces, making it a pervasive health concern2.

THE COMPOSITION OF SECOND-HAND SMOKE

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Second-hand smoke is a toxic mixture of over 7,000 chemicals, including at least 250 that are known to be harmful, with more than 60 being recognised as carcinogens3. These chemicals are divided into two categories: side stream smoke (the smoke from the burning end of a cigarette) and mainstream smoke (the smoke exhaled by the smoker)4. Both types contain harmful substances like nicotine, carbon monoxide, formaldehyde, and benzene, among others5.

THE IMPACT OF PASSIVE SMOKING ON ASTHMATICS

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Now, let’s focus on how passive smoking affects individuals with asthma, a chronic respiratory condition characterised by airway inflammation and hyperreactivity9. Asthmatics are particularly vulnerable to the harmful effects of second-hand smoke, as their already sensitive airways are further irritated and compromised.

  1. Increased Asthma Symptoms: Passive smoking can trigger or worsen asthma symptoms in asthmatic individuals. When exposed to second-hand smoke, they may experience increased coughing, wheezing, shortness of breath, and chest tightness10.
  2. Exacerbation of Asthma Attacks: Asthmatics exposed to second-hand smoke are at a higher risk of having severe asthma attacks11. These attacks can be life-threatening, requiring emergency medical intervention.
  3. Reduced Medication Efficacy: Smoking in the vicinity of asthmatic individuals can reduce the effectiveness of their asthma medications12. This means that even if they are diligently following their treatment plan, exposure to second-hand smoke can undermine its benefits.
  4. Long-Term Lung Damage: Chronic exposure to passive smoke can lead to long-term lung damage in asthmatics. It may increase the risk of reduced lung function over time, making it harder for them to breathe and manage their asthma13.



  1. U.S. Department of Health and Human Services. (2006). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.
  2. American Lung Association. (2021). Secondhand Smoke. https://www.lung.org/quit-smoking/smoking-facts/secondhand-smoke
  3. U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General.
  4. World Health Organization. (2007). The Scientific Basis of Tobacco Product Regulation: Second Report of a WHO Study Group.
  5. American Cancer Society. (2021). What’s in a Cigarette? https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/what-causes.html
  6. Centers for Disease Control and Prevention. (2020). Health Effects of Secondhand Smoke. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/index.htm
  7. U.S. Department of Health and Human Services. (2010). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General.
  8. National Cancer Institute. (2011). Secondhand Smoke and Cancer. https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/second-hand-smoke-fact-sheet
  9. Global Initiative for Asthma. (2019). Global Strategy for Asthma Management and Prevention.
  10. U.S. Department of Health and Human Services. (2006). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.
  11. Vardavas, C. I., & Anagnostopoulos, N. (2010). Passive smoking and children’s health. Expert Review of Pharmacoeconomics & Outcomes Research, 10(3), 251-254.
  12. Eisner, M. D., & Iribarren, C. (2001). The influence of cigarette smoking on adult asthma outcomes. Nicotine & Tobacco Research, 3(1), 27-37.
  13. Patil, S. P., Krishnan, J. A., Lechtzin, N., Diette, G. B., & Ingebrigtsen, T. S. (2007). Smoking and asthma: Association, mechanisms, and implications for therapy. Expert Review of Respiratory Medicine, 1(1), 85-101.
  14. U.S. Department of Health and Human Services. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline.
  15. American Cancer Society. (2021). How to Quit Smoking or Smokeless Tobacco. https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking.html
  16. American Lung Association. (2021). How to Protect Yourself and Others from Secondhand Smoke. https://www.lung.org/clean-air/at-home/protecting-your-home
  17. World Health Organization. (2009). WHO Report on the Global Tobacco Epidemic, 2009: Implementing Smoke-Free Environments.

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