What should you know about smokers bronchiolitis?

Bronchiolitis affects the narrow air passages that carry air deep into the lungs. Swelling and mucus can make breathing noisy or laboured. It is commonly associated with a viral infection in babies and toddlers, while tobacco smoke can irritate the airways and make respiratory symptoms harder to manage. Smoke exposure includes cigarettes, shisha, vaping aerosols and smoke carried on clothing or furniture.

A child may have a cough, wheezing, a runny nose, fever, faster breathing or difficulty feeding. In an adult who smokes, ongoing cough and breathlessness may have another cause, such as chronic bronchitis or an underlying lung condition, so the label should not be assumed without an examination. Read more about [Bronchiolitis](/conditions/bronchiolitis/), [Cough](/symptoms/cough/) and [Wheezing](/symptoms/wheezing/).

Keep the air around the affected person smoke-free and avoid fragranced vapours or other airway irritants. Offer small, frequent drinks if a child is alert and able to swallow, and allow rest. Follow the clinician’s instructions about medicines; do not give a child an over-the-counter cough remedy unless a healthcare professional has advised it.

Arrange a clinical assessment if symptoms are new, worsening, or interfering with feeding, sleep or normal activity. A clinician may check breathing effort, oxygen level and hydration. Some children may need inhaled treatment for a particular problem, but a nebuliser is not suitable for every case. See [Nebuliser Treatment](/treatments/acute-and-urgent-care/nebuliser-treatment/) and [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/).

Seek urgent medical help if breathing is very fast or difficult, the ribs or neck pull in with each breath, the lips look blue or grey, there are pauses in breathing, or the person is unusually sleepy and hard to wake. Get prompt advice if a baby is taking much less fluid, has noticeably fewer wet nappies, or symptoms are getting worse. Fever with breathing difficulty also deserves medical assessment; you can learn more about [Fever](/symptoms/fever/).

Ask what is causing the breathing symptoms, whether the pattern fits bronchiolitis or another lung problem, and what signs should trigger urgent help. Ask how to reduce smoke exposure at home, whether any inhaled treatment is appropriate, and how much fluid or feeding to aim for while the person is unwell.