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The Impact of Smoking and E-Cigarette Use on Asthma

by Rachael Joyner, NP, FNP-BC, APRN | Nurse Practitioner, Duke Smoking Cessation Program

Graphic with logo for National Asthma and Allergy Awareness Month
May is National Asthma and Allergy Awareness Month

May is national Asthma and Allergy Awareness Month, which is a great time to discuss some key facts on the impact of smoking and vaping on asthma, a condition affecting 4.6 million children and over 20 million adults in the U.S, according to the latest National Health Interview Survey data from 2021.

Photo of Neasha Graves
Neasha Graves, MPA

I spoke with Neasha Graves, MPA, the Environmental Health Outreach Manager at the Center for Public Engagement with Science at UNC—Chapel Hill, on what she and her colleagues are doing to get the word out about the harms of tobacco and e-cigarette smoke. Neasha will be speaking at the upcoming 2024 NC Asthma Summit on May 9, 2024.

When you are talking to people about the impact of smoking or e-cigarette use on asthma and allergies, what do you say?

We often work with local health department staff and nonprofit staff who have a focus on healthy homes and family health. This includes providing trainings for public health professionals, who conduct home visits with young families, and school nurses for example. We share the research that shows the impact of smoking on the development of asthma. It is not a surprise to anyone that smoking worsens asthma. However, people may not know how a pregnant mom or newborn baby’s exposure to tobacco smoke increases the potential risk of developing asthma, the severity of their asthma, and the difficulty in fighting off other respiratory illnesses.

When it comes to vaping, we talk about the surge in vaping in the United States in the last 10 to 15 years. Working alongside researchers, our team has developed lesson plans around vaping for high school students—one of the most critical populations to educate, in part because the Surgeon General cites youth and young adults’ attraction to flavored vaping liquids. When researchers like UNC immunologist Dr. Ilona Jaspers are speaking in community settings, they help dispel the myth among people who might think, “I’m vaping water.” Presentations and hands-on learning activities show people that they are actually damaging lung cells with something much more dangerous than water, including heavy metals and nicotine. It alarms people when they learn in our trainings about the amount of nicotine that is in certain vapes.

How does this issue impact vulnerable populations?

Early life exposure to tobacco smoke diminishes lung development among children; therefore, pregnant women and children are high-risk populations. Another vulnerable population includes low-income children. Their exposure to tobacco smoke at home could result in poor asthma outcomes, and unfortunately, the lack of access to treatment can impact recovery.

How does your team address the topic of secondhand and thirdhand smoke?

I think people are still learning about thirdhand smoke [the chemicals that settle on surfaces once the cigarette is put out]. We’re working to help public health professionals build the communication skills needed to share information about tobacco smoke and other environmental asthma triggers with families. For example, we often explain thirdhand smoke this way: “Secondhand smoke is the smoke you can see. Thirdhand smoke is the smoke [or residue from smoking] you cannot see, but you know it is there because you can smell it in the carpet, on your clothes, or in your car.” Child care providers seem to understand that concept; some have shared with us how they smell tobacco smoke in infant and toddler’s clothing when they are dropped off for care in the mornings.

To learn more about our evidence-based, virtual tobacco treatment training programs, visit our website at Our Summer Comprehensive Tobacco Treatment Specialist Training will take place July 15-23. Upcoming CE Short Course training topics include Tobacco Dependence Pharmacotherapy (May 9), Intensive Behavioral Health Approaches to Tobacco Treatment (May 21), and Tobacco Treatment in Adolescent and Young Adult Populations (August 7).

About the Author

Photo of Rachael Joyner, DNP, FNP-BC, APRN
Rachael Joyner, DNP, FNP-BC, APRN

Rachael Joyner, DNP, FNP-BC, APRN, is a family nurse practitioner with the Duke Smoking Cessation Program. She holds a National Certificate in Tobacco Treatment Practice and received her Doctorate in Nursing Practice from the University of Florida. She loves working collaboratively with patients to help them become tobacco free.


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