If I quit, will my inhaled steroids finally work?

Yes. Recovery of steroid sensitivity starts within weeks of quitting and is clear by 2-3 months. For many asthmatic smokers, this is a dramatic change — asthma finally becomes controllable.

During the first weeks of withdrawal, can my attacks get worse?

Possibly, but temporarily. The cough of withdrawal can be scary, but it is different from an attack. Keep your emergency bronchodilator within reach and tell your GP or pulmonologist you are quitting — close follow-up is useful in the first weeks.

My child has asthma, I smoke but outside the house. Is that enough?

Sadly no. Smoke clings to clothes, hair, skin ("third-hand smoke") and keeps releasing toxic compounds for hours. It remains an asthma trigger for children. The only real protection is full cessation.

Is the e-cigarette compatible with asthma?

Better than the conventional cigarette, but not harmless. Several recent studies show an association between chronic vaping and asthmatic symptoms in young people. As a transition towards full cessation, yes; as a long-term solution, no.

How long before reducing inhaled steroids after quitting?

To discuss with your GP or pulmonologist. Often, after 3-6 months off cigarettes with good asthma control, doses can be progressively reduced. Never reduce a long-term treatment on your own.

And if I cannot quit?

You are not alone. Stack the resources: tobacco-cessation specialist (quitting will be the priority in your respiratory follow-up), substitutes, varenicline, support (groups, Aria). A relapse is not failure — most smokers need several attempts before a lasting quit.

Asthma and tobacco: why quitting smoking radically changes how well you control your attacks

50% of asthma deaths happen in smokers. Tobacco worsens attacks and neutralises inhaled steroids. Quitting improves your lungs in under 2 months.

June 18, 2026 Aria

The scientific basis on quitting smoking was reviewed on a voluntary basis by Pr. Bertrand Dautzenberg , a tobacco specialist, in order to rule out gross, potentially dangerous errors. It reflects positions commonly shared by health professionals and health agencies, without always corresponding exactly to his thinking or his practice. He is not the author of this text; he has only carried out a vigilance review of it.

If you live with asthma and you smoke, here is a figure that should give you pause: almost half of asthma deaths happen in smokers. Tobacco does not just make your attacks worse — it neutralises a large part of your treatment. Here is why, and what concretely changes when you quit.

Why tobacco makes asthma worse

× 2 to 3 the frequency and intensity of attacks in asthmatic smokers. And a significantly higher risk of severe asthma decompensation.

WHO, global data on asthma and tobacco

The big trap: steroid resistance

This is the most insidious effect of tobacco on asthma.

Smoking cessation is the absolute priority in the therapeutic management of asthmatic smokers. Without quitting tobacco, inhaled steroid therapy is not effective.

EM Consulte, French study on steroids and smoker's asthma, 2008

How much it changes when you quit

24-48 hours after quitting: CO disappears from the blood, oxygenation improves.
2-4 weeks bronchial inflammation begins to drop.
Under 2 months a +15% improvement in lung function in asthmatic patients (measured by FEV1).
3 months fewer attacks, less often, less severe.
6 months less reliance on emergency medicines (Ventolin).
1 year much better controlled asthma, inhaled steroid doses often reduced.

Safe quit tools for asthmatic patients

Passive smoking: critical for asthmatic children

In United Kingdom

Your questions

If I quit, will my inhaled steroids finally work?

Yes. Recovery of steroid sensitivity starts within weeks of quitting and is clear by 2-3 months. For many asthmatic smokers, this is a dramatic change — asthma finally becomes controllable.
During the first weeks of withdrawal, can my attacks get worse?

Possibly, but temporarily. The cough of withdrawal can be scary, but it is different from an attack. Keep your emergency bronchodilator within reach and tell your GP or pulmonologist you are quitting — close follow-up is useful in the first weeks.
My child has asthma, I smoke but outside the house. Is that enough?

Sadly no. Smoke clings to clothes, hair, skin ("third-hand smoke") and keeps releasing toxic compounds for hours. It remains an asthma trigger for children. The only real protection is full cessation.
Is the e-cigarette compatible with asthma?

Better than the conventional cigarette, but not harmless. Several recent studies show an association between chronic vaping and asthmatic symptoms in young people. As a transition towards full cessation, yes; as a long-term solution, no.
How long before reducing inhaled steroids after quitting?

To discuss with your GP or pulmonologist. Often, after 3-6 months off cigarettes with good asthma control, doses can be progressively reduced. Never reduce a long-term treatment on your own.
And if I cannot quit?

You are not alone. Stack the resources: tobacco-cessation specialist (quitting will be the priority in your respiratory follow-up), substitutes, varenicline, support (groups, Aria). A relapse is not failure — most smokers need several attempts before a lasting quit.

sources

WHO, Technical note on the relationship between smoking and asthma.
Specificity of smoking cessation in asthma patients, ScienceDirect, Revue des Maladies Respiratoires, 2020.
How effective are steroids in asthmatic smokers?, EM Consulte, 2008.
British Thoracic Society / SIGN, British guideline on the management of asthma, updated 2024.
NHS, Asthma — Living with asthma, 2024.