How to ease your asthma symptoms today… without an inhaler: I see more patients struggling with the condition at this time of year than any other. These are all the options that can help, reveals DR PHILIPPA KAYE

The long, tremendously hot summer is finally over. The mornings are crisp, the evenings are drawing in – and if I hadn’t looked out of the window, my patients would have told me. 

As the seasons change, the number of people coming to see me with asthma symptoms goes up. Autumn and winter are tough on the airways, with coughs and colds, cold air, damp, mould and smoke all triggers.

Many patients rely heavily on their inhaler – a commonly prescribed medication designed to ease the symptoms – at this time of year.

However, there are two issues with this. The first is that the NHS has recently changed the inhaler it offers most patients – which has left many confused (more on this later).

The second is that there are a variety of lifestyle changes that patients can make that will keep their symptoms under control, which are just as important – if not more – than using an inhaler.

And there are so many patients who need to hear this.

Asthma is a long-term condition, affecting around 5.4million people in the UK, where the airways in the lungs are hyper-reactive and inflamed, so when something irritates them they tighten, swell and fill with mucus. 

That makes it harder to breathe and can cause coughing, wheezing and a tight chest.

Asthma can start at any age and is more likely if you have allergies, eczema or hay fever, or if it runs in your family. 

It is not a trivial condition: around four people in the UK die from an asthma attack every day, and many of those deaths are thought to be preventable.

Winter piles on the pressure. Seven in ten people with asthma find cold, dry air makes their symptoms worse by irritating sensitive airways. We also spend more time indoors, where viruses spread easily – and respiratory infections, which peak between October and March, are one of the commonest triggers of asthma attacks.

But that’s not the only issue facing my asthma patients. As I mentioned earlier, many of them are struggling with their medication too. 

Take Leon. For decades, the 43-year-old has relied on the familiar blue salbutamol inhaler, reaching for it at the first sign of a tight chest or wheeze. Then he was prescribed a new inhaler – and, well, didn’t use it.   

He only came to see me to sheepishly ask for help when he’d finally run out of the half-finished blues stashed in his car, his work bag and the bottom of his bedside drawer. 

He is far from alone. Asthma treatment changed at the end of 2024 and many patients have found the change confusing.

In short, the majority of patients are no longer offered the classic blue inhaler. That’s because it only does half the job. 

Now, for adults and children over 12, the aim is to treat the inflammation every time you treat the symptoms. That means a single combination inhaler – which comes in several different colours including red and white – containing a steroid plus formoterol, a fast-acting reliever. 

Depending on your asthma, you use it only when you need it, or daily with extra puffs when symptoms flare. If you are newly diagnosed, this is what you are likely to be given.

I can see why the change is confusing for patients. Many have used the blue inhaler all their life and found it helped. Switching to a new drug can feel strange and scary. 

But patients who fail to use their drugs as instructed could be putting their health – even their life – at risk.

However, an inhaler, even the right one, should not be the only step patients take to control their asthma.

At this time of year, one tip I always recommend my patients is wrapping a scarf loosely over the nose or mouth while out and about. It might sound almost too simple, but it works.

It warms and moistens the air before it reaches the airways, softening that shock of cold, which can inflame them.

Another crucial step is regular exercise. Many patients tell me they feel like exercise isn’t for them because they worry about exacerbating their symptoms.

However, staying active strengthens the heart and lungs, which can ultimately help control asthma. It doesn’t need to be too strenuous. Anything from a brisk walk to jogging, cycling or swimming will do.

In cold weather, warm up indoors first and keep your inhaler close by. If exercise reliably sets off symptoms, it may mean the medication regime needs changing, so anyone experiencing this should see a GP.

Weight matters too. Carrying extra pounds is linked to more troublesome asthma, and even modest weight loss can ease symptoms. 

A balanced diet with plenty of fruit and vegetables helps.

For patients who smoke, quitting is quite simply the best thing you can do for your health – as it will ease lung symptoms, not to mention lower your risk of other diseases like cancer.

Asthma sufferers also need to do everything they can to protect themselves from infections. More often than not, this means getting vaccinated when the time comes.

Anyone who uses a combination inhaler continuously or regularly will be eligible for a free flu jab, and can ask their GP or pharmacist whether they qualify for Covid or RSV (another nasty winter bug) vaccines. 

Remember to wash hands regularly during these colder months, to reduce the risk of infection. And, for asthma patients, any early cold symptoms need to be taken seriously – particularly breathing problems.

Another important step is tackling damp and mould in the home, as these can aggravate the lungs. This can be done by opening windows to ventilate rooms and wiping mould away where it is spotted. 

Some of my patients also use an air purifier in the bedroom, to keep the air free of irritating particles. This can be particularly useful around Bonfire Night, which reliably leads to an influx of asthma patients to A&E with symptoms set off by the smoke.

It’s crucial too that patients keep track of their symptoms – particularly in the night. Waking up coughing, wheezing or breathless is a red flag that your asthma isn’t under control. 

Any patient who hasn’t had an asthma review with their GP in the past year, or who is reaching for their inhaler more than usual, should book one now. And, of course, it is so important that patients know what to do in an emergency.

Anyone struggling to breathe, who can’t speak in full sentences or whose inhaler isn’t helping, should call 999 straight away.