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Asthma in Children and Second-Hand Smoke

Frequently asked questions and resources on how smoking affects children with asthma

What is asthma?

  • Asthma is a chronic lung disease that affects the small airways in the lungs. Asthma increases swelling in the small tube-like airways deep in the lungs. It can also cause an increase in mucous deep in the lungs. During an asthma attack, the airways narrow, from the swelling and mucous, until it is difficult to push air out of the lungs, making it hard to breathe. Signs that your child is having an asthma attack include: coughing, wheezing, shortness of breath or difficulty breathing, chest tightness or chest pain.
  • Reactive airway disease is what doctors call asthma-like symptoms, of wheezing and cough, in very young children or babies.

How do I know if my child has asthma?

  • Young children with asthma will often cough at night or when running around. You may hear a high-pitched squeak when your child breathes out (which doctors call a wheeze). Albuterol, a medication used for asthma, will often make children feel better and breath more easily.
  • Pediatricians will often treat children for asthma if they have these symptoms of cough, wheeze, and difficulty breathing.
  • Pediatric Pulmonologists, lung doctors for children, can also diagnose children with asthma by doing a breathing test called a “Pulmonary Function Test (PFT).” This tests also helps keep track of whether your child’s lungs are getting better or worse.

What is second-hand smoke?

  • Second-hand smoke is the smoke breathed out by the person smoking and the smoke coming off the end of the cigarette. The same chemicals and toxins in second hand smoke will stick to the clothes, skin, and hair of the person smoking.
  • Cigarette smoke has over 4,000 chemicals in it. Many of these chemicals are known to cause cancer. Carbon monoxide and formaldehyde are two examples of chemicals found in cigarette smoke.

What does asthma have to do with second-hand smoke?

  • Children have young and developing lungs that absorb more of the toxins from second hand smoke as compared to more mature lungs.
  • Babies and small children have immature immune systems that can be affected by smoke, causing them to have more ear infections, respiratory infections, and wheezing.
  • Exposure to tobacco smoke as a young child can increase the likelihood of your child developing asthma as he/she grows.
  • Second hand smoke can cause asthma attacks in children with asthma. Asthma attacks can be deadly.
  • Smoke causes the inflammation (swelling) and mucous in the lungs to increase.

How is asthma treated?

  • Asthma is treated with a medication called Albuterol, which helps to open up the airways temporarily during an asthma attack. If your child’s doctor thinks that your child’s asthma is affecting his/her lifestyle, the doctor will prescribe a different inhaler that tries to decrease swelling deep in the lungs. This is called a “controller” inhaler or inhaled corticosteroid.
  • Asthma is also treated by protecting your child from things in the environment that make their asthma worse; this can include: allergens and smoke.

How can I prevent asthma attacks in my child?

  • You as the parent can prevent asthma attacks by giving your child a smoke-free environment! Even when you smoke outside, smoke sticks to your skin, clothes, and hair. You continue to breathe out smoke even after you stop smoking. This can expose your child to smoke when you kiss, cuddle, and interact with him/her. Making sure your child is not exposed to smoke can save him/her from very dangerous asthma attacks.

What about e-cigarettes?

  • E-cigarettes vaporize liquid nicotine and other chemicals in order to give the same effect a regular cigarette, or relaxation to the person smoking it.
  • They produce less second-hand smoke but they still release chemicals into the environment for your child to breathe in.
  • It is important to use e-cigarettes outside in an open area away from windows or doors that open into the house or car where your child might be.
  • Pregnant women should not use e-cigarettes, as the chemicals she inhales are absorbed into her blood and given to the baby, and the nicotine she inhales decreases the amount of blood that her baby receives (by making the blood vessels in the placenta smaller).

How to quit smoking?

Quit telephone hotlines (English and Spanish)

  • American Lung Association – 1-800-LUNG-USA
  • Tennessee Tobacco Quit Line – 1-800-QUIT-NOW

Quit websites

Quit Apps for smart phones

  • QuitGuide
  • QuitSTART

Quit support groups on social media

  • SmokefreeUS
  • Smokefree Women

Medications to help me quit

  • Talk to your doctor about a nicotine replacement therapy (NRT) that will help you quit.
  • Some choices include patch, gum, lozenge, inhaler, and nasal spray.
  • Most quit hotlines will send your first round of medications.
  • In addition, your local health department often provides some of these medications for FREE.

Johnson City resources

  • TIPS Program with ETSU – attempting to eliminate smoking in pregnancy and improve birth outcomes in Northeast Tennessee – (423) 439-6705 or
  • Beat the Habit program – Health Resource Center a the Wellness Center in Johnson City – (423) 915-5200
  • Nicotine-Free Mountain Empire – 214 Commerce Street, Kingsport, TN 37662 – (423) 246-2017
  • BABY & ME tobacco-free program – pregnant and new mothers get free counseling and resources, along with $25 grocery gift card incentives to quit smoking – (423) 975-2200


  1. ETSU Smoking Cessation
  2. Center for Disease Control, Tips from former smokers.
  3. Center for Disease Control, Smoking and Tobacco Use, retrieved 2018.
  4. Tennessee Department of Health, Tennessee Tobacco Quitline, retrieved 2018.
  5. American Lung Association, I want to quit smoking, retrieved 2018.
  6. Center for Disease Control, Learn how to control asthma, retrieved 2018.