The research, published in BMJ Open, analysed posts written by teenagers and their parents from Asthma UK’s online forum between 2006 and 2016.  It found that the social stigma of asthma can play a role in teenagers choosing not to use their inhalers.

Through the forum, teenagers often talked about feeling embarrassed about being diagnosed with asthma and having to use an inhaler. Some said that people around them had negative reactions to their condition which could lead to mocking and social exclusion.

Several reasons were given as barriers to using their inhalers including:

  • Asthma being portrayed on TV and in films as an emotional problem suffered by anxious people
  • Dislike of being labelled with a chronic illness
  • Shape of some inhalers ‘resemble sex toys’
  • Concerns about side effects such as weight gain and spots
  • Forgetfulness
  • Lack of routine
  • Not having a good inhaler technique

Lead researcher Dr Anna De Simoni, from the Asthma UK Centre for Applied Research at QMUL, said: “I was surprised by the stigma associated with asthma and using inhalers. I don’t think I have ever discussed this aspect in my consultations with teenagers.  

“I am a GP and these findings have changed my own practice.  I now check social issues associated with asthma diagnosis and inhaler treatment and discuss how accepting my patients are of their inhaler devices and potential side effects.

“I take more time to talk to teenagers and their parents about their roles in dealing with the practicalities of treatment, like managing prescriptions and reminding them of inhaler taking times.”

There is a high prevalence of asthma among teenagers and a greater rate of asthma attacks, hospitalisation and death than in younger children. The chance of an asthma attack is reduced when a person uses their preventer inhaler more than 80 per cent of the time as recommended by their GP or asthma nurse, but research suggests that for teenagers usage can be as low as low as 25-35 per cent.

Dr Andrew Whittamore, GP and Clinical Lead at Asthma UK, said: “It is concerning that that the social stigma of asthma continues to be underestimated. We need to be acutely aware of how children and young adults have a need to feel normal.

“This research shows that urgent action needs to be taken to improve awareness of asthma. Regularly taking a preventer inhaler is important to treat the underlying inflammation that leads to symptoms and a higher risk of a life-threatening asthma attack.”

More information

Research paper: ‘What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum’. Anna De Simoni, Robert Horne, Louise Fleming, Andrew Bush, Chris Griffiths. BMJ Open. doi:10.1136/bmjopen-2016-015245