GINA recommendations in adults with symptomatic mild asthma and a smoking history

Abstract

The Global Initiative for Asthma (GINA) 2019 report makes a major change in asthma management by recommending that adults and adolescents with mild symptomatic asthma (Step 1) receive as-needed low-dose inhaled corticosteroid (ICS)–formoterol rather than a short-acting β2-agonist alone [1]. At step 2, daily low-dose ICS is recommended, and GINA 2019 considers low-dose ICS–formoterol reliever as an alternative “preferred controller”. The GINA recommendation to use as-required ICS-formoterol in symptomatic mild asthma is applicable to smokers with a low cumulative smoking history, but evidence is lacking for its effectiveness in smokers with medium and high tobacco use