After smell of smoke

My husband has taken up smoking. Joy. Since I have discovered, he doesn't bother attempting to hide the smell. Can the 'after' smell of the smoke on him be a trigger for ashtma? Tonight after he had a cigeratte outside, he came in washed up and chewed some gum and even though I had taken some ventalin everytime he was near me I couldn't stop coughing. Had to get out of bed and leave........ to come here and post. Fine now.

[paxista]

He decided to take up smoking? What the (pick your favorite expletive) for? What's his smoking history? Have you invested in a doghouse?

[marieann288]

I believe he smoked cigerattes when he was younger and when I met him he would smoke an odd colt but quit within a few weeks of knowing him.  He was diagnosed with diabetes and moved to a new poistion at work where his work mates smoke alot. I think he started becaue he was stressed, people around him were smoking and it would help in reducing weight, which I hate to say has. His sugar levels are completely under control without meds since the weight loss. Unfortunately I hate the fact he smokes and he's addicted!

[allmymarbles]

It is an unfortunate fact that smoking can keep your weight down. Which is worse his smoking, or his suffering from diabetes? Hard question to answer. My husband quit smoking some years ago, gained about 40 pounds, and developed diabetes II, along with some of its degenerative side effects. One of his medications, to which he had a bad reaction, put him in the hospital with a burst appendix. I wish he would start smoking again. His life expectancy is better with smoking than it is with diabetes.

You obviously object to smoking. But that is personal to you, and should not be visited upon your husband.

[marieann288]

Wow, what an interesting response. I take no objection to the first paragraph at all and provides an interesting perspective.

However I do have the right not to live with a non smoker. I would never ever choose to live with a smoker. I do not associate with smokers, none of my friends smoke, I don't smoke why should I be subjected to the stench especially if it could possibly be triggering my asthma. Its a health issue for me. There are other means to loose weight rather choosing to smoke especially when you have an asthmatic wife. Do you know what its like to have someone who smokes breathe over you, or want to kiss you, or even touch you, its gross and disgusting. At first he took more care to cover it up, but now it is less and less to the point if he doesn't wash up afterward and I say something he sometimes is resentful. Well too bad. I didn't sign up to live with a smoker. It could very well become a deal breaker for me. So yah its personal to me, and whose to say what I 'should' or 'shouldn't' do? Isn't he going to be happy living alone when he comes homes one day because I didn't 'visit it' upon him.

[allmymarbles]

My daughter is a non smoker. Her husband smokes outside, but not in the house. The arrangement works and neither forces his/her will on the other. If you love your husband perhaps you can make an agreement such as this. Of course, if you don't love him, then smoking is probably a secondary issue.

As far as losing weight is concerned, for a dietetic this is extremely difficult. It is the diabetes itself that accounts for extra weight. If a diabetic and a non-diabetic took in the same number of calories, all else being equal, the diabetic would weight more.

[marieann288]

You are serious? How is me asking if the after smell of smoking can trigger asthma equate to me trying to exert my will over someone else? Possibly you could consider that if my husband 'loved' me he wouldn't have lied about smoking in the first place and then continue to smoke when realizing that it is a health issue for me and repulsive.

That's nice your daughter doesn't care about her husband's health and they have an arrangement, that is their choice. Did he smoke when she met him? If so then she had a choice. I have not. My husband did not smoke when I met him. I should not have to be near someone who stinks nor kiss someone whose mouth smells like an ashtray so you can think I 'love' my husband. And where do you think he smokes in the house? I would have left by now, of course he goes outside.

I'm sorry your husband has diabetes and anyone who thinks smoking is a good choice for a diabetic needs to give their head a shake since its a known fact that smoking is another risk factor for heart disease. Getting off one's butt and excercising and eating healthy foods works. Maybe if you loved your husband you would guide him to healthy food choices and provide healthy meals, or would that be forcing your will upon him? Sounds to me as though you might be a smoker yourself and you would like your husband to join the club again.

Another thing to ponder, we don't have the right to expect to do anything we want in life without consequence. And we do need to force our will upon others for society to effectively function. Laws, household rules for example are all forms of 'forcing' someone's will. It's this liberal attitude that some people have that they make it sound like it's wrong that is bent and has become an influence as to why our society is having so much trouble with young people today.

[marieann288]

I have a friend whose father was an abusive, angry alcoholic who worked as a prison guard. My friend's mother had enough and chose to move into her own apartment. There she stayed and said she would not return until he reformed his ways. She lived on her own for an entire year. Her husband continued his ways had a heart attack, almost died, but she refused to returned until he reformed. Eventually he did quit drinking, chose a healthier lifestyle, quit smoking, lost weight, started walking everyday, joined AA retired. That was 35 years ago. They did reconcile and they lived together happily for another 30 odd years. She is still alive but he has passed.  Now tell me what was the real act of love? Did she not love him when she left? Or was she simply setting a boundary, which was difficult, but the actual act of love for herself and him. If she had not, they would not have had those good years.

[caregiver222]

You raised some interesting questions.

Asthma is a "conditionable" response.

In trhe literature, Pavlov's dog was presented with a buzzer and/or light and a short while later a steak. After a time, presentation of the buzzer/light will precipate salivation.

Thus, if an asthmatic is in, for example, a bedroom where there has been an asthmatic trigger, and the bedroom is then cleansed of that trigger, the mere fact of entering the bedroom may precipitate an attack.

Fortunately, in the absence of an actual trigger, these "conditioned" attacks will diminish and eventually disappear.

And no, I couldn't live in the same house with a smoker.

[bsmsl]

Are you saying that asthma is equivalent to a panic attack?

[caregiver222]

No.

I am saying that asthma is a "conditionable response".

Pavlov demonstrated conditioning with a dog. He presented steak juxtaposed with either a whistle or a light. The dog salivated. Then he only blew the whistle or showed the light. Even though there was no steak there was salivation. This called a conditionable response.

Let us say that a someone's house has an allergic substance. Perhaps a cat. A person enters the house and an asthmatic episode takes place. They leave. They come back again and the cat is there. Another episode. Then they come to the house and the cat is no longer there. They have another attack because the house has become associated with the trigger.

That being said a panic attack can easily take place during a severe asthmatic episode. They can be very frightening.

[bsmsl]

Well, I beg to differ with you.  

A panic attack is fastly different from an asthma attack.  I am hypersensitive to ANY odor.  When I am not in an asthma flare I may or may not experience an attack when exposed to an odor, but I usually do have a second of panic fearing an actual attack.  However, that is nothing like an actual asthma attack and passes very quickly.  When I am in a flare, I always have an asthma attack when exposed to odors unless I have taken a neb very recently.  

Don't confuse the physchological response of panic with the physiological responses of an asthma attack.  It confuses people, and many people are not treated properlyduring an asthma attack because others actually believe it is just panic.  An asthma attack involves several physiological reactions - Inflamation (inflammation) of the airways which causes excess mucous production and also bronchial muscle spasms.  These are real physiological responses that need propper treatment.  Trivializing these reactions under any circumstance is dangerous to the person experiencing them.  

As far as a person having an attack in a house where they knew a cat used to live and were by your theory "conditioned" to have an attack, think about this - it can take YEARS to remove all the cat dander from a house where a cat has resided.  It is probable that the asthmatic is actully having a reaction to the actual cat dander that is still in the house.  Not just a panic attack that looks like an asthma attack.

Your last statement does acknowledge that an actual asthma attack triggers a sense of panic.  That is understandable when someone can't breathe and they feel like they are being suffocated.  The reverse as described by your premise is not likely.  While maintained stress can trigger an attack/flare, panic does not trigger asthma attacks.  

We will just have to disagree.

[Jaquta]

Yes, smoking can be a trigger for asthma.  Passive smoking carries risks.

Most addictions point to an underlying emotion problem.

Cause and effect.  I personally don't think your problem is psychological.  Yes, stress can trigger asthma attacks.  I expect panic disorder could trigger asthma too.  Correct breathing techniques are good strategies for both conditions.

Your husband may like to look at what has caused him to turn to cigarettes.

[gray325]

I am in a similar situation. Met my boyfriend online. My profile stated that smokers need not apply. He was
(I realized after I moved to another town to live with him) trying to quit, so considered himself a non-smoker. The first six months were stressful for me. He hated himself for smoking, so all I could do was quietly support his efforts while wondering if I'd made a huge mistake. When he succeeded in quitting, I was soooo proud of him. Since then I have mentioned to him from time to time how much I appreciate his quitting and how I know it wasn't an easy addiction to break. Fast forward 18 months, he has joined motorcycle club (club, not gang) and started smoking again.

What do I do? I can't deny the fact that smoking grosses me out -  by my own admission, I am overly sensitive to fragrance/odours. Smoking makes him smell nasty. If we were dating, it would be a deal breaker. I'm emotionally involved now, however,  and hate feeling that I have to choose between the guy I love and my standards.

Good luck with your decision.

[caregiver222]

The fact that asthma is a conditional response is a medical fact.

My example with the cat may not have been on the mark, but I was trying to make a point.

There does not necessarily have to be an actual trigger to cause an asthmatic attack. That was my point.

Secondly at no point did I ever state that a panic attack was the same as an asthmatic attack. Don't put words in my mouth.

I stated that is it's possible to have both at the same time.

[Jaquta]

If asthma were strictly a conditioned response I would have expected to have seen it in the DSM-IV.  Any little known piece of information can be announced fact if supported by the right financial sponsor.  Drug companies are among the worst for misrepresenting data.

I find it offensive that someone would suggest that this medical condition is conditioned.

There will be a catalyst.  I think it is erroneous to say that an asthma attack can occur with no trigger.

Maybe indirectly you did.  You're the one talking about asthma being a conditional response.  I think the emotional response you are talking about is best described as anxiety.  Anxiety/ panic -same diff.

You're right, asthma can be extremely frightening.

I still believe in this instance that the woman's problem is physiological not psychological.
If one were to want too one could conduct an experiment to find potential triggers.

As someone who has had life-threatening asthma I wouldn't be in a huge hurry to put myself at risk.  I would take note of when I was feeling SOB though.

[caregiver222]

I did not state that all asthmatic attacks are strictly conditioned respones.

Nor did I state that all asthmatics are suscptible to such conditioning.

Let's go back to square one.

Conditioned responses have been studied extensively, noteably by Dr. B.F. Skinner and Dr. Kurt Salzinger, past president of the AMA.

Being "offended" by a medical fact is absurd. Forgive me for having spent a year in a laboratory studying the variety of conditioned physiological responses.

I am not suggesting or stating this patient's problems were due to Pavlovian conditioning.

Asthma is the result of the body responding to the presence of an antigen, or non-self substance.

Curiously, it is possible to substitute something for that antigen.

Many physiological reactions can be conditioned. An angina attack can be a conditional response.  This is rarely the case. Just as it is rarely the case with asthmatics.

When a stimulus is presented with a triger for numerous times the stimulus becomes associated with the trigger. This takes place under lab conditions.

If the stimulus is presented again and again without pairing with the trigger, the response tends to diminish and eventually disappear.

A person who is frightened of snakes can experience an increased heartrate when shown an imnage of a snake.

This is Pavlovian conditioning.

There is a voluminous amount of data on the conditioning of biological responses.

It is only one of the factors to consider when evaluating an asthmatic patient.

[Jaquta]

Square one, in my opinion, was a woman (probably with a history of asthma) complaining of coughing in the presence of her husband who had taken up smoking.

All conditions have the potential to be influenced and affected by emotional stress.

If you were to suggest that my cancer was due to a conditioned response I would feel equally outraged.

I'm lost on the physiological conditioning because aren't what we talking about physiological responses to psychological conditioning?

Whatever we're talking about please go easy on those poor little lab creatures.

[bsmsl]

marieann288,

To answer your question, ANY smell can trigger an asthma attack.  The molecules that ceate odors are irritents.  

I really do think that you and your husband should seek couseling.  My husband was being VERY rude to me about my asthma, and I asked my dr talk to him.  That has helped, but he never apologized.  It could be that your husband doesn't really understand asthma and thinks you are over reacting like mine did.  I know my husband and I would benefit from counseling to get over the hurt he has caused with his lack of compassion.   When dealing with these issues, I force myself to remember that I made a commitment for life and divorce is not an option for me.  That is my personal choice, but that keeps me hanging on when things are tough.  You will do what you think is best for you.
I hope that helps you.

[bsmsl]

I would like to take a look at the information you have that says that asthma is a conditioned disease.  Every thing I have read, which is rather extensive, has always said that an asthma attack is triggered only by agents that cause inflamation (inflammation) in the bronchial tubes which leads to congestion and broncho spasms.  Prolonged stress can contribute to asthma symptoms because stress hormones are inflamatory.  A person might fear going into a room where they have had a bad asthma attack before, but I have read nothing that indicates in any way that just going into the room would cause an asthma attack.  I fear the smell of fried chicken, but when I am relatively healthy I wait and see what the smell does to me.  If I am not healthy, I don't give it a chance to have any affect on me.  It is not worth the risk.

Would you please share links to your information with us?

[caregiver222]

A hundred years ago Dr. Makenzile demonstrated the first lab example of learning and classical conditioning by inducing bronchospasm in certain asthmatics through the presentation of stimuli that were not in and of themselves antigens. He described a woman who developed wheezing at the sight of the image of a rose under glass.

American Journal of Science 1886, 91: 45-47

[bsmsl]

I would apreciate something much more current than that.  The environment the study was done in could not be controlled in any way 124 years ago.  It is highly probably that the women was reacting to any number of uncontrolled environmental conditions such as climate, drafts, or particals carried in a draft and her wheezing coincidently occurred when the flower was placed in front of her.  Not to mention, how do we know that the flower was sealed in the glass or that the glass did not tip allowing some pollen to escape and trigger a reaction.  Could dust have been stirred while placing the rose infront of her triggering her wheezing?

By today's standards, the study highly suspect.  Please try to find something no older than say 20 maybe 30 years.  

Thank you.

[Jaquta]

For me I would need to see more evidence of how the experiment was conducted and of what controls were in place.  It seems perfectly plausible though.

We still use penicillin and that was discovered donkey years ago.

I think we're all perhaps trying to say the same thing but through different languages.

1886 does seem a bit old.  But then we still use laws from many, many moons ago.  I think that's also about when women first voted in my country.  Or at least when one of our mountains erupted and people signed our contentious treaty.

I feel that caregiver may post (?his/ ?her) his entire thesis here if given the opportunity.  It sounds as though he may have considerable education/ experience in this field.

Classical conditioning sounds 'interesting'.  For me I can't get my head around the distinction between physiological and psychological.  For me they need to be black and white, either or, but not both (or at least not initially).  My thinking is quite limited but that's where I'm at.  

It was big of you to ask caregiver because although I was curious I was also not willing to ask.

We should all be working together to understand.  I know I have biases and sometimes it can be difficult to let those go.

[Jaquta]

I was thinking about this yesterday.  I was sitting in the doctor's surgery reading a magazine when someone sat down close to me smelling of smoke.
Maybe caregiver is right in that for some people it does trigger memories of past events (which for some asthmatics have been traumatic).
Perhaps it's a combination of both -actual trigger and learned response.  ??

[bsmsl]

Sorry it has taken me so long to get back to you, but I knew it would be long and take a while.  I have been busy and my asthma is acting up.  That is life.

There are several conditions that mimic asthma that asthmatics need to be aware of.  Those include but are not limited to vocal cord dysfunction, panic and acid reflux.

Vocal Cord Dysfunction (VCD) is a physical response of a muscle spasm of the vocal cords to a physical trigger which include all asthma triggers as well as singing and laughing.  The muscle spasm causes a wheezing sound just like asthma only it is during inhalation not exhalation.  It is characterized by difficulty inhaling as opposed to an difficulty exhaling (however some people do have difficulty inhaling with asthma mainly because they can exhale to make room for fresh air).  VCD attacks do not respond to asthma medications and are treated with breathing exercises.

Panic attacks are often confused with asthma attacks.  They frequently do occur in conjunction with asthma attacks because what can be worse than not being able to breathe?  Panicking is understandable.  Panic attacks are learned behavior for most people.  Some people do have panic disorders and it is not a learned behavior for them.  It is a psychological response. Asthmatics need to learn to distinguish between pure panic attacks and asthma attacks combined with panic and learn techniques to short circuit the panic aspect of the attack with relaxation techniques.  Memories of past events such as bad asthma attacks are learned and trigger panic not asthma.  

I have certainly experienced this.  Fried chicken triggered my worst asthma attack ever.  Now whenever I smell fried chicken (especially if it is strong) I can have a panic attack along with the asthma attack.  I work at controlling the panic and me controlling the situation, not letting the panic control me.

I also have VCD which is triggered by smells. I had a difficult time learning to distinguish between the different aspect of my attacks.  What I learned to do was start VCD breathing techniques at the start of any attack while I was getting to my rescue inhaler.  I learned that this took care of the VCD and panic aspects of any attack.  If sob continued I knew it was asthma and that I needed to treat that.  

When my asthma suddenly worsened two years ago and I learned that odors were triggering my attacks, I frequently mistook my attacks for panic.  How could the severity of my reactions to something as simple as an odor (both artificial fragrances and foods) possibly be real?  I had had reactions to fragrances most of my life and grew up with parents who reacted adversely to fragrances. Difficulty breathing around fragrances was not a new concept to me, it was the severity of my reactions that caused my disbelief.  Consequently, I would stay in dangerous situations far longer than I should have.  

Through out most of history, asthma has been considered a psychological disorder and was treated with counseling.  An ancient Egyptian physician did recognize that asthma attacks increased during the rainy season.  An ancient Rabbi noted that asthma attacks increased after colds (Rabis were the physicians for the ancient Jews).  There are other examples of ancient physicians who recognized physiological aspects of asthma.  It wasn't until the 1960's, when NSAIDs were developed that other treatments for asthma came into existence.  Since that time, death rates due to asthma attacks have been drastically reduced as the physiological aspects of asthma were treated.

The following is an excerpt from: http://www.medicalnewstoday.com/info/asthma/asthma-history.php   The article also contains the examples given above and several others of historically acknowledged physiological causes.

"At the beginning of the 20th century asthma was seen as a psychosomatic disease - an approach that probably undermined any medical breakthroughs at the time. During the 1930s to 1950s, asthma was known as one of the holy seven psychosomatic illnesses.

Asthma was described as psychological, with treatment often involving, as its primary component, psychoanalysis and other 'talking cures'. A child's wheeze was seen as a suppressed cry for his or her mother. Psychoanalysts thought that patients with asthma should be treated for depression. This psychiatric theory was eventually refuted and asthma became known as a physical condition.

Asthma, as an inflammatory disease, was not really recognized until the 1960s when anti-inflammatory medications started being used."

I would still like to see what recent research is available supporting caregiver22's position.

I do acknowledge the existence of learned response to an asthma trigger as being panic (I have experienced that).  As far as an asthma attack itself being learned,  I will need more recent research confirming that position.