Cuba - air quality?

It's a little hard to weigh in on medical advice for other people so please take my anecdotal information for limited value. I have asthma - pretty well controlled at this point in my life and I seldom use an inhaler. I went to China and Egypt this year - both known for filthy air so perhaps a useful comparison for Cuba. I was nervous. I tried to start on a maintenance inhaler before I left but I had forgotten how much I hate the way that thing makes me feel. I bailed on it and went without. I was fine in both countries. The air in Beijing was clear but Shanghai air was filthy. Cairo air was really dirty as well.

I had no trouble. I did bring my Albuterol but did not have to use it.

I was in Cuba for about a week in October, 2016 (in Havana for business). I had heard about the bad air quality, but did not notice any difference in quality from where I live in the U.S. It was a good time of year to be there, and I was hoping that would help the air quality - it was just cool enough for me to wear short-sleeved blouses, and take a sweater in case I got too cool. (I have exercise-induced asthma, so notice this kind of issue occasionally.)

There are plenty of cabs in Havana that are new cars, just the same, or similar to, those you see in the U.S. In addition to the beautiful older vehicles.

Thanks for the replies! Obviously I'll consult my doc, but she will probably just offer me the maintenance inhaler again. She insists it didn't make me gain weight, but it did, twice. She does an amazing otherwise with my complicated allergy shots, though.

Smog, which is what you are asking about, is very related to atmospheric conditions at any given time. So anyone's experience in Cuba may not be the conditions you would encounter. Avoiding the hot summer months would generally help.

I did not notice smog being in issue when I was there in February 2016. But it wasn't that hot and there were some strong winds most days. Outside of Havana, there should be little to no issues with smog.

What could be a serious risk for you is riding in cars. Except for the newer Chinese cars, most all the others, including the classic American cars pre-1959, have horrible exhaust issues. A convertible should be ok, but riding inside them can be very hard on one's breathing even for a normally healthy person. Modern tour buses are fine.

Another potential issue for you could be indoor air quality. I noticed a lot of musty places, even when the atmospheric humidity was relatively low. Hotels were the worst since one has to sleep there. Musty bedding and furniture is to be expected. If that is something that will affect you, be prepared.

On a side note, you reference maybe going out to rural areas. How do you plan to do so without being on some sort of tour? Havana is (relatively) easy to navigate on your own, but Cuba does not have a transportation system to speak of and certainly not one that works for tourists. Renting a car is not advisable, although hiring a car and driver is common (but you run into the issue of car exhaust).

Thanks, Douglas, for the very detailed reply. I just don't know how the exhaust will affect me, and that's my main concern. I'm glad the air quality may not be too bad outside of summer, since I plan to visit around late October. I know there is a degree of unpredictability here, as with any kind of weather.

I should have been clearer about the tour - I would like to go to rural areas IF we decide to join a tour. We'd consider it in Cuba for the reasons you say - easier to get to the rural areas, and helps keep me out of cars. But it's not our normal travel style. I'm leaning towards it for sure, though.