Background: Caregivers of children with asthma provided with a written asthma action plan (WAAP) are reported to be more confident in their ability to provide care for their child during an asthma exacerbation. However, little is known about how a WAAP impacts on their care processes that contributed to this increased confidence.

Background:Smoking is a known trigger of asthma exacerbation. Yet some patients with asthma continue to smoke. Little is known about their smoking literacy, which is defined as an individual's capacity to comprehend and use healthcare information relating to smoking. This study aimed to determine the level of smoking literacy amongst patients with asthma, who were smokers (S) and non-smokers (NS). Methods: Standardised questionnaires were administered by trained research assistants to adult multi-ethnic Asian patients with asthma, who were managed in three public primary care clinics (polyclinics) in Singapore. Demographic data and information on a subject's understanding and effects of smoking on health and complications were collected. The latter were computed into knowledge scores and the mean scores between S and NS were compared using the independent two-sample t-test with adjustment for potential confounders via multiple linear regression. Results: A total of 174 S and 183 NS were recruited with a higher proportion of younger male S. Overall, the knowledge score for S was significantly lower than NS (absolute mean difference (AMD) = −0.95, 95% confidence interval (CI) −1.58 to −0.33, p = 0.003). This was particularly for smoking associated specific respiratory disease (AMD = −0.23, 95% CI −0.44 to −0.02, p =0.034) and asthma symptoms (AMD = −0.73, 95% CI −0.98 to −0.47, p < 0.001). The differences persisted after adjusting for other important factors such as gender and education level. Conclusions: Compared with NS, S generally reported lower scores in their overall knowledge, and the knowledge in the association between smoking and specific respiratory diseases and asthma symptoms. Smoker patients may require measures to raise their smoking literacy during the counselling to optimise their smoking cessation success rates.

Introduction:One-third of adult asthma patients smoke cigarettes despite smoking being a known trigger of asthma exacerbation. This study aims to describe the behaviour of asthmatic patients who smoke and explore the reasons why they continue to smoke cigarettes even when unwell. Methods:A cross-sectional questionnaire survey was conducted on adult asthma patients at primary care clinics in Singapore. One hundred and seventy-four asthmatic smokers (AS) of four ethnic groups, both genders, aged 21-50 years were recruited. Demographic data and smoking characteristics, reasons for smoking, and experiences during their attempts to quit were collected and analysed using the statistical software STATA version 12. Results:The median age of AS was 30 years. Seventy-five percent were males and mostly Malays (58%). Seventyone percent had at least secondary education. Eighty-six percent started smoking before 20 years old. Ninetyeight percent smoked less than 10 sticks per day and 51% smoked ≤5 pack-years. Thirty-eight percent smoked within 5 minutes of awakening. AS cited reasons such as stress relief (79%), peer pressure (36%), influence from family members who smoke (40%), think better (35%), staying alert (57%), and relaxed (53%). Although 77% believed smoking worsened their asthma, they continued to smoke. Restlessness (43%), mood swings (27%), difficulties in concentration (25%) and irritability (24%) were common symptoms encountered in those who attempted to quit. About 44% did not refrain from smoking even when they were ill. Conclusion:Adult asthmatic smokers continued cigarette smoking to relieve stress, maintain mental alertness and avoid withdrawal symptoms. Implementing a programme to address smoking behaviour and withdrawal symptoms is paramount towards successful smoking cessation.