Understanding asthma: What are your misconceptions? This World Asthma Day find out more about asthma and challenge your misconceptions.

May 05, 2021
A family laugh together in the shade of a tree on a sunny day

Today is World Asthma Day, when people across the asthma community come together to raise awareness of the challenges being faced by millions of people living with asthma, their families, friends and caregivers. Asthma is a common condition, affecting approximately 358 million people worldwide, and causing a major health and financial toll1,2,3. This year’s World Asthma Day theme is both important and timely, calling on the asthma community to uncover asthma misconceptions by combatting misinformation and sharing lesser-known facts about asthma. 

Since its founding in 1998, World Asthma Day has taken place each May, organized by the Global Initiative for Asthma (GINA), an international advocacy group working tirelessly to support people with asthma. As it represents a central milestone in the asthma community calendar, we are marking the day by calling out and exploring some key myths and misconceptions about asthma.

So, what are your asthma misconceptions? As it’s hard to know what you don’t know, we’ve picked out three key topics related to asthma where misconceptions are prevalent: 

Myth: All asthma is the same

Asthma is not a ‘one size fits all’ disease. When you think about it, it’s not surprising that a disease that affects more than 1/3 of a billion people worldwide1 manifests in different ways for different people, but it is frequently mischaracterized. 

Asthma has many different causes, and can present differently in each person it effects. For many people with asthma, their condition is caused by allergens such as dust, pet dander and pollen4. For others, non-allergic triggers can be the cause, like smoke, cold weather or exercise5. Symptoms can happen all year-round (chronic) or be seasonal6

As with many diseases, asthma symptoms are mild for some people and severe for others, although asthma attacks may be dangerous even for someone with an apparently mild disease7. Some people may not even realize their symptoms are caused by asthma. 

However, severity and different triggers are not the only reasons for differences in asthma. For women with asthma, symptoms may be more or less frequent depending on the phase of their menstrual cycle8. Quality of life and outcomes also differ between men and women with asthma9.

So what does this mean? Having uncovered this misconception what can we do about it? The main takeaway here is that each person with asthma needs to work with their healthcare professionals to find an approach that fits their personal disease and experience10, which may include a referral to a specialist (pulmonologist or allergist). Understanding and fully testing for all of these different types and manifestations of asthma is very important in order to achieve the best possible treatment and management11.  

Myth: Asthma has nothing to do with climate change and the environment

People with asthma are particularly vulnerable to the impacts of air pollution and climate change. Although the ongoing climate emergency is important to everyone, air pollution and climate change may have a particular impact on people with asthma12

We know that environmental concerns are important to an increasing number of people13, and carbon footprint may become one of multiple relevant factors in inhaler preference for a number of asthma patients14. Inhalers account for around 3% of the carbon footprint of the UK’s National Health Service (NHS), the same as around half of their entire food and catering footprint15. Most of these inhaler emissions come from the propellants used in certain inhaler types known as pressurized Metered Dose Inhalers (pMDIs) 16. However, not all inhalers have the same carbon footprint. Dry powder inhalers (DPIs) are another inhaler category and typically have a low carbon footprint compared with pMDIs as they do not need a propellant to function16

Myth: Asthma attacks are normal

Asthma attacks and frequent symptoms are not normal. Because asthma is a common disease, it may be easy to underestimate its severity: people experiencing frequent symptoms who often need their reliever medication are considered to have ‘uncontrolled’ asthma, and are at risk of worsening symptoms, hospital visits, and even death17. As many as 60% of people with asthma do not have full control of their symptoms18, for varying reasons. Some patients, particularly teenagers, report feeling embarrassed about taking their medication in front of their peers19. Other studies have suggested that asthma control may be more difficult to maintain if patients have a complicated treatment regime with multiple inhalers, or find their inhaler difficult to use and have not received proper training20,21. For a lot of people, they just don’t realize that frequently experiencing symptoms is not normal22

Whatever the reason may be, uncontrolled asthma is a major problem. If you have asthma and regularly experience symptoms, talk to your doctor about why this could be in order to find new management approaches together. 

Our work in asthma research spans over 30 years, and we continue to strive each day to reimagine medicine and solutions to support asthma care. We recognize the importance of engaging with and supporting the asthma community to help patients learn about their asthma and how to control it. Education and health literacy are key tools to help better manage asthma, and represent an important shared goal across the asthma community. This World Asthma Day we invite you to join us in challenging assumptions and misconceptions. What were you surprised to learn about asthma?

Seeking novel therapies against a range of respiratory diseases

At Novartis, our focus is on improving the lives of the hundreds of millions of people living with respiratory diseases, including chronic obstructive pulmonary disease (COPD) and severe allergic asthma.

References:

  1. GBD Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma. Lancet Resp Med. 2017;5(9)691-706.
  2. AAFA. My Life with Asthma Survey Findings Report. Available from: https://www.aafa.org/media/1684/my-life-with-asthma-in-2017-survey-findings-report.pdf [Last accessed: April 2021]
  3. Katsaounou P, et al. Still Fighting for Breath: a patient survey of the challenges and impact of severe asthma. ERJ Open Research. 2018;4(4):00076.
  4. AAFA Allergens and allergic asthma. Available from: https://www.aafa.org/allergic-asthma/ [Accessed April 2021
  5. AAAAI Asthma triggers and management. Available from: https://www.aaaai.org/conditions-and-treatments/library/asthma-library/asthma-triggers-and-management 
  6. Asthma UK Types of Asthma. Available from: https://www.asthma.org.uk/advice/understanding-asthma/types/ [Last accessed March 2021].
  7. GINA Pocket Guide 2020. Available from: https://ginasthma.org/wp-content/uploads/2020/04/Main-pocket-guide_2020_04_03-final-wms.pdf [Accessed April 2021]
  8. Zein J, Asthma is different for women. Curr Allergy Asthma Rep. 2015 June;15(6): 28.
  9. Leynaert B et al. Gender differences in prevalence, diagnosis and incidence of allergic and non-allergic asthma: a population-based cohort. Thorax. 2012;67(7):625–31.
  10. Chung KF, Personalised medicine in asthma: time for action. European Respiratory Review. 2017. 26: 170064.
  11. WebMD, Types of Asthma. Available from: https://www.webmd.com/asthma/types-asthma [last accessed April 2021]. 
  12. D’Amato G, et al. Effects on asthma and Respiratory allergy of climate change and air pollution. Multidisciplinary Respiratory Medicine 2015;10:39.
  13. Pew Research. A look at how people around the world view climate change. Available from: https://www.pewresearch.org/fact-tank/2019/04/18/a-look-at-how-people-around-the-world-view-climate-change/ [Accessed April 2021]
  14. Liew KL et al. How do we choose inhalers? Patient and physician perspectives on environmental, Financial and ease-of-use factors. Thorax 2017. 72 (Supplement) P280. 
  15. NHS England. Delivering a 'Net Zero' National Health Service. 2020.
  16. North and East Devon Formulary and Referral. The Environmental Impact of Inhalers. Available from: https://northeast.devonformularyguidance.nhs.uk/formulary/chapters/3.-respiratory/the-environmental-impact-of-inhalers [Last accessed March 2021].
  17. GINA, Difficult to treat and severe asthma in adolescent and adult patients, Diagnosis and Treatment. 2018.
  18. CDC Uncontrolled Asthma among Adults, 2016. Available from: https://www.cdc.gov/asthma/asthma_stats/uncontrolled-asthma-adults.htm [Accessed April 2021].
  19. De Simoni A, et. al. What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum BMJ Open 2017;7:e015245.
  20. Bender B, Overcoming barriers to nonadherence in asthma treatment, Journal of allergy and clinical immunology, Altering The Course Of Asthma. 2002. 09:6 (Supplement) S554-S559.
  21. AL-Jahdali H, et al. Improper inhaler technique is associated with poor asthma control and frequent emergency department visits. Allergy Asthma and Clinical Immunology 9, 8 (2013).
  22. Bidad N, Understanding patients' perceptions of asthma control: a qualitative study. European Respiratory Journal. 2018. 51: 1701346.