Are severe asthmatics still smoking?

Introduction: Smoking worsens all aspects of asthma and smoking cessation improves them. We assessed the percentage of severe asthmatics who smoke and correlation of smoking with their perception of dyspnoea and quality of life. Methods: Data were collected in 1333 patients [adult (>18 yrs) and children (6–17 yrs, through caregivers)] with severe persistent asthma in 9 countries via an online survey by GfK on behalf of Novartis in 2016. Results: Of the total adult population 20% were smokers, 24% ex-smokers and 2% vapist. In the caregivers population, 19% were smokers, 16% ex-smokers and 7% vapists. 63% of adults and 68% of caregivers avoided smoky premises, suggesting awareness on impact of passive exposure on asthma; however, 19% and 13% were active smokers respectively. Smokers used OCS for an average 21 days; non-smokers for 19 days (Table). Positive correlation was seen between days that severe asthmatics used OCS according to both GINA (Spearman’s ρ=0.23) and perceived control (Spearman’s ρ=0.11). Current smokers were significantly more often diagnosed with anxiety (47%) and depression (41%) than non-smokers (40% and 27% respectively) and ex-smokers (42% and 28% respectively)[z-test,α=0.05] Conclusion: Smoking is common in severe asthmatics across different countries and is positively associated with asthma severity, depression and anxiety. There is need to implement smoking cessation strategies in severe asthmatics that should also address anxiety and depressio