Mixing Second-Hand Smoke and Cystic Fibrosis

It’s no secret that smoking is bad for you. We’ve all known it since health warnings began appearing on cigarette packs in 1965. It’s taken us a little longer to figure out that breathing in second-hand smoke is equally unhealthy, but now we know the truth about that, too. Anybody who is regularly exposed to second-hand smoke is at risk for developing the same types of illnesses as in those who smoke, but people with cystic fibrosis (CF) have an even greater risk of complications from second-hand smoke exposure.

Girl being annoyed by father smoking a cigarette at the kitchen table
Scholastic Studio 10 / Getty Images

Why Second-Hand Smoke Is Bad

Cigarette smoke contains hundreds of toxic chemicals that are known to cause cancer and other diseases in people who smoke. Smokers get the greatest concentration of chemicals, but second-hand smoke contains enough toxins to cause disease in people who regularly breathe it in.

Cigarette smoke also contains irritants that cause inflammation of the airways, and it damages the cilia that line the airways causing mucus to become trapped. Inflammation and mucus build-up are problems that already exist in people with cystic fibrosis. Breathing in second-hand smoke makes these problems worse.

What Second-Hand Smoke Does to People With CF

Studies have shown that exposure to second-hand smoke can cause problems for people with cystic fibrosis above and beyond the problems that it causes for other people.

Weight loss or poor weight gain: The first study about CF and second-hand smoke was conducted at a summer camp in 1990. The study found that kids with CF who were regularly exposed to second-hand smoke at home gained much more weight during the two second-hand smoke-free weeks of camp than the children who were not regularly exposed to second-hand smoke at home.

Increased respiratory infections: Ever since the 1990 study, many studies have been done that found people with cystic fibrosis who are exposed to second-hand smoke suffer from more frequent and more severe lung infections than do those who are not exposed to smoke.

Decreased lung function: A study conducted at The Johns Hopkins University in 2008 produced some startling results. The Hopkins study found that people with cystic fibrosis who are exposed to second-hand smoke at home have lung functions 10% lower than did those with CF who are not exposed to smoke.

How Much Smoke Exposure Is Okay?

There really is no safe amount of smoke; even a little bit of exposure can cause problems for people with cystic fibrosis. Ideally, you shouldn’t breathe in any smoke at all, but that’s pretty hard to do in a world full of smokers. So, how are you supposed to get along in society without suffering the consequences of breathing in second-hand smoke? The best answer is that you’re going to have to find a balance between the things you can control and those that you can’t.

Some things you can do:

  • Insist on keeping your own home and car completely smoke-free.
  • If you have friends or family members who smoke, ask them not to smoke around you or your child with CF.
  • Explain the extent of the problems that second-hand smoke can cause, and ask your friends and family for their cooperation.
  • If your family and friends are skeptical or being stubborn, enlist the help of your CF Care Center team and ask them to write a letter about the dangers of second-hand smoke.
  • Stay away from restaurants and other public places that allow indoor smoking. Even if you sit in the non-smoking sections, you will still be exposed to second-hand smoke.
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  • Collaco, J.M., et al. “Interactions Between Secondhand Smoke and Genes That Affect Cystic Fibrosis Lung Disease”. JAMA.2008;299(4):417-424.
  • Schechter, M.S. “Non-genetic influences on cystic fibrosis lung disease: The role of sociodemographic characteristics, environmental exposures, and healthcare interventions”. Seminars in Respiratory and Critical Care Medicine. 2003;24(6):639-652.
  • Schecter, M.S. “CF Lung Health Anthology Part 1: Secondhand Smoke and CF”. 2008. Cystic Fibrosis Foundation.

By Lori Alma
Lori Alma, RN, is a registered nurse and cystic fibrosis expert who assists families in a Florida Department of Health program for special needs children.