Brief Answer: Considerations Detailed Answer: Hello and thank you for submitting your question. Cigarette smoke and respiratory tract infections (such as influenza A) pose especially difficult problems for asthmatics, as you are unfortunately experiencing. What happened in your lungs during the influenza infection (as well as being in a different environment, Thailand, with different climate conditions) is your lungs responded with inflammation and bronchoconstriction, which are the main events in asthma. Although your body has cleared the influenza infection, there is still residual inflammation in your lungs that is making you hypersensitive right now to things that can trigger asthma. Your medication regimen sounds appropriate – and inhaled steroid to help with inflammation and a medicine to open your lungs against bronchoconstriction. Another possibility might be considering adding a prednisone or steroid taper, which only your doctor can determine necessary in your case. It is very reasonable to minimize exposure to cigarette smoke, especially at this time. It has been shown that secondhand cigarette smoke is a risk factor for lung disease, however this is usually in cases of patients exposed at an early age, or for continual prolonged periods of time (years). I hope this helps and that you are breathing better soon. Sincerely, Dr. G

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