Updated 30 October 2017

Smoking and asthma: 4 questions answered

It is a given that smoking is bad, but just how bad is smoking for people with asthma? We weighed in with a pulmonologist.

We've all heard the following in a conversation: “My 86-year-old asthmatic grandmother smokes and she is as healthy as a horse! Smoking can’t be that bad.”

Or can it? Is this just a misconception, or is there actually some truth to this statement? We spoke to Associate Professor Richard van Zyl-Smit, head of the Lung Clinical Research Unit (LCRU) at the University of Cape Town Lung Institute, to find out.

How bad is smoking for people with asthma?

Smoking is bad for everyone but especially for asthmatics, according to Prof Van Zyl-Smit. “Since asthmatic airways are already overly prone to go into spasm because of pollen, dust etc., smoking only adds a whole lot of extra noxious gasses and particles into the mix,” he explains.

The side effects of smoking for asthmatics are twofold. Prof Van Zyl-Smit says that not only will the smoke affect your chest but, in addition, stop your medication from working as well as it should. Therefore, both the pollution and the less effective medication will worsen your asthma control.

Will smoking worsen asthma?

Prof Van Zyl-Smit says that smoking will definitely make your asthma worse for the reason that it will also increase your risk of contracting flu, pneumonia and tuberculosis. “In the long term, smoking while suffering from asthma may result in stiff and dilated airways and eventually emphysema.

Tobacco use is a major cause of death worldwide, according to the World Health Organisation (WHO), due to the high levels of nicotine. Here are some negative effects that nicotine can have on your body:   

  • Increases the amount of mucus in your airways
  • Damages the small hairs that keep your airways clean
  • Increases the burning sensation in your lungs 
  • Causes coughing

Will an inhaler cancel the effects of smoking with asthma?

Prof Van Zyl-Smit says that if, as a smoker, you frequently use your emergency inhaler, it is a strong signal that the inflammation in your airways is out of control.  The inhaled smoke and chemicals stop your preventer medication from working properly and increases the need for reliever medication. “Stopping smoking is the only option here. You might be okay for a few years but once the damage is done there is no going back,” he says.

Will an inhaler cancel the effects of smoking without asthma?

Asthma inhalers are specifically developed for targeting asthmatic inflammation and airway spasm. “The inflammation that is caused by smoking is not exactly the same as that of ‘asthma inflammation’ so using an inhaler just because you smoke is of no value and potentially dangerous.” If you have developed emphysema from smoking, then inhaled medication (bronchodilators) may be used to open the airways.

Read More:

Low-income kids more likely to have asthma

6 ways to relax your airways during exercise

Asthma: a needless killer of our time


Ask the Expert

Asthma Expert

Professor Keertan Dheda has received of several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others.Read his full biography at the University of Cape Town Lung Institute

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