Smoke and Asthma

CEBU, Philippines – The widespread firecracker explosions in the recent New Year's celebrations have reportedly resulted in an increased incidence of asthma attacks in the population. While this year's situation has not really worsened compared with the same period in previous years, it is sad enough that it still occurs, given that the asthmatics have probably already learned to take the necessary precautions. And firecracker smoke is not the only smoke that can trigger an asthma attack.

Most smokes - if not all - are bad for the health. Especially so for the millions of children and adults with asthma. With those who have asthma, any exposure to smoke - whether cigarette or firecracker smoke - can lead to an asthma attack. And frequent exposure to smoke can make asthma symptoms even worse.

Cigarettes - being the more habitual source of smoke than firecrackers - "do not cause asthma, in the sense that people don't become allergic to cigarette smoke," but contact with cigarette smoke either by actively smoking or through second-hand exposure can trigger asthma symptoms, says Kenneth Rosenman, MD, chief of the division of occupational and environmental medicine at Michigan State University in East Lansing, Michigan, in the US.

An asthma attack occurs when your airways become irritated and inflamed. Cigarette smoke is one item on a long list of potential asthma triggers. "We can describe an asthmatic as someone who has sensitive airways, the same way some people have [sensitive] skin - so any irritating stimulant, like cigarette smoke or [other air pollutants that wouldn't] produce a reaction in a normal person, will lead to wheezing or an asthma attack," explains Richard Castriotta, MD, professor of medicine and associate director of the division of Pulmonary, Critical Care, and Sleep Medicine at the University of Texas Medical School at Houston.

Though many airborne pollutants can trigger an asthma attack, cigarette smoke is especially dangerous. "The single most important environmental factor that can make asthma worse is tobacco smoke," says Miles Weinberger, MD, professor of pediatrics and director of the Pediatric Allergy & Pulmonary Division at the University of Iowa in Iowa City.

Dr. Weinberger cites statistics that show a fivefold increase in hospitalizations among children who have asthma and live with smokers. Living in a house with a smoker - even a smoker who says that the smoking takes place outside of the home - can make it very difficult to control asthma, says Weinberger. Keep in mind that even traces of smoke on clothing can irritate the sensitive airways of someone with asthma and can trigger an asthma attack.

In fact, Weinberger has done research in Iowa City that shows that close to 90 percent of children with asthma who live in a non-smoking household can achieve good control of their asthma. The proportion drops dramatically, to only 50 percent, for children who live in homes with smokers, he says. Likewise, adults who smoke and also have asthma may find that they are much less responsive to asthma medications that are known to be effective in asthmatics who do not smoke.

Pregnant women are advised not to smoke and to avoid second-hand smoke. There are many good reasons for that advice because cigarette smoke leads to low birth weight and higher infant mortality. One little known reason to avoid exposure to smoke during pregnancy, though, is that data show a link between a mother's exposure to smoking - either her own or someone else's - and an increase in her baby's future risk of asthma attacks.

Additionally, there is research that shows "if your parents smoke [during your childhood], you're more likely to develop asthma," says Dr. Rosenman.

In a recent, comprehensive set of guidelines for asthma management, the National Heart, Lung, and Blood Institute strongly recommends the following steps for preventing asthma attacks:

If you smoke, stop smoking now.

Do not permit smoking in your car, home, or anywhere around you.

If your child has asthma attacks, find caregivers that don't smoke or daycare centers where there is an absolute no-smoking policy.

If you smoke and are also the parent or close relative of a child with asthma, talk to your doctor and get help from family and friends to kick your habit. There isn't a better gift you could give your child - or yourself, for that matter. (www.everydayhealth.com)

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