Detectable serum or salivary cotinine associated with increased odds of readmission for asthma (OR 1.18) in US kids. Parent reported tobacco exposure was highly unreliable and was not associated with readmission (only 35% reported tobacco exposure, but 80% had positive saliva). Howrylak, Peds 2014;133:e355
For competitive swimmers, note FINA doping control rules (based on the World Anti-Doping Agency regulations). Most asthma medications are on the Prohibited List including inhaled steroids and inhaled Beta2 agonists.
Therefore, elite athletes with asthma must apply for special permission to use these medications, known as the “Therapeutic Use Exemption” (TUE) program. If competing at FINA events, then you apply directly to the FINA Doping Control Review Board to have their applications considered. Lower level athletes should apply to their national anti-doping body.