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Health Issues

Tobacco and Children with Asthma

By: Kamakshya Patra, MD, FAAP

Staying clear of cigarettes and other tobacco products is one of the most important ways parents can help their children—especially those with asthma—breathe easy.

Up in Smoke: Effects on the Lungs

Tobacco smoke contains nicotine and thousands of other chemicals, many with known health effects. Exposure to tobacco can cause lung problems even before a child's first breath.

Research shows tobacco and nicotine exposure—both in the womb and after a child is born—can:

  • Interfere with healthy lung development, which begins before birth and continues through about age 15. The effect is long-lasting, with evidence suggesting teens exposed to secondhand smoke perform worse on lung function tests.

  • Cause more frequent sickness, because it is more difficult for a child's immune system to fight off respiratory infections.

  • Trigger asthma flare-ups and attacks, with wheezing, coughing, chest tightness and other breathing difficulties. In severe cases, the symptoms can be life-threatening.

  • Cause the best available asthma-control medications to not work as well.

Clear the Air Kids Breathe!

More than 40% of children who go to the emergency room for asthma live with smokers.

For children who have asthma, however, the frequency and severity of asthma attacks improves greatly if smoke exposure stops.

Steps that can help children with asthma:

  • Keep your home and car smoke-free. Opening a window doesn't protect against tobacco smoke. In addition, cigarette smoke and vapor can settle into upholstery, clothing, and carpeting. Children who play on or near contaminated surfaces may develop breathing problems.

  • If your state allows smoking in public areas, seek out restaurants and other places that have their own no-smoking policies. According to the Centers for Disease Control and Prevention, non-smoking sections where people smoke nearby don't protect against secondhand smoke, even if they have filtered ventilation systems.

  • Make sure your child care centers and schools have and enforce tobacco-free policies, with no smoking allowed anywhere in the building at any time. This includes off-campus school events.

  • Teach children to avoid secondhand smoke and the importance of never starting the habit themselves.

  • If you smoke, resolve to quit. It is very difficult to be a smoker and not expose your child, and children of smokers are more likely to start smoking later.

  • Seek help for tobacco dependence if your child has asthma and you struggle to quit smoking. Nicotine is one of the most addictive drugs known and changes brain structure and chemistry. Some people can stop tobacco use without medication, but many cannot. The nicotine patch, nicotine gum, and nicotine lozenge are available over the counter. Bupropion (Wellbutrin, Zyban), varenicline (Chantix), nicotine nasal spray, and nicotine oral inhaler are available by prescription.


When you quit smoking, or take other steps to avoid tobacco exposure, your child will not need as much asthma medicine. Quitting will help keep your child out of emergency room and hospital. Both of you will be able to breathe easier!

Additional Information from


About Dr. Patra:

Kamakshya Patra, MD, FAAP, is a practicing pediatrician at J.W. Ruby Memorial Hospital in West Virginia. He is also an assistant professor of pediatrics at West Virginia University. Within the American Academy of Pediatrics, Dr. Patra is a member of both the Section on Tobacco Control and the Section on Hospital Medicine. ​​

Last Updated
Section on Tobacco Control (Copyright © 2017 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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