Asthma is a common lung condition that affects the breathing tubes (airways) that carry air in and out of your lungs. Asthma causes wheeze and cough, and can make it difficult to breathe. New Zealand has one of the highest rates of asthma in the world, affecting up to 1 in 7 children and 1 in 8 adults.
This page focuses on asthma in adults. For information about children with asthma, see asthma in children.
If you have asthma, your airways are sensitive and react to certain triggers such as allergens (substances that cause an allergic reaction), viruses, cold or humid weather, exercise and air pollutants such as cigarette smoke.
These triggers cause your air passages to tighten up, swell on the inside (become inflamed) and produce more mucus.
As a result, the airways become narrower, making it difficult for air to move into your lungs, and even more difficult for air to move out.
Learning about asthma, what causes it and how it is treated can help you avoid triggers and keep your symptoms under control.
Seek urgent medical help if you have severe asthma symptoms.
What causes asthma?
Asthma is thought to be caused by a combination of genetic and environmental factors.
Asthma and allergies are closely linked. About 70 to 80% of asthma in New Zealand is associated with allergies. Often people with asthma also have eczema (allergic skin rash) or hay fever, or have close family members who have asthma, eczema or hay fever. The tendency for these 3 conditions to occur together is known as atopy. If you are atopic, allergies can be a trigger for your asthma.
Certain things in our environment thought to have a role in causing asthma include:
air pollution (such as tobacco smoke or petrol fumes)
What are the symptoms of asthma?
Asthma is ongoing and your symptoms may come and go.
Common symptoms of asthma include:
difficulty breathing, feeling out of breath or as though you can't get enough air out of your lungs
a tight feeling in your chest like something is squeezing or sitting on your chest
wheezing (a whistling, musical or squeaky noise in your chest)
a cough, which can be worse at night or in the morning.
If you have any of these symptoms, see your doctor so they can assess if this is due to asthma or something else.
Severe asthma symptoms
From time to time, your symptoms may get gradually or suddenly worse. Seek urgent medical help if you have any of these severe symptoms:
it is difficult to talk
your lips and/or fingernails have a bluish tinge
your nostrils flare when you breathe
the skin around your neck and/or ribs pulls in when you breathe
your heart is racing
it is hard to walk.
For severe asthma symptoms, you should use your reliever inhaler immediately and call an ambulance on 111 or go to your nearest Accident & Emergency clinic.
What triggers asthma symptoms?
Learning what triggers your asthma and finding ways to avoid or reduce the effects is an important part of managing your asthma.
a description of your asthma symptoms now and in the past
listening to your breathing with a stethoscope
checking how your lungs are working with breathing tests, such as a peak flow meter (a device that measures changes in your breathing over the day) and spirometry (a machine that measures lung function).
In some cases, more detailed testing may be required, such as a skin-prick test to test for allergens or, rarely, a chest x-ray to rule out other conditions.
Once a diagnosis is made, your doctor will prescribe the type of medicines you need to take and will set up an asthma action plan. This plan reminds you how to manage your asthma every day and how to recognise and manage your asthma when your symptoms get worse.
How is asthma treated?
While asthma cannot be cured, the correct use of medication combined with other self-care measures means that symptoms can be well controlled in most people.
Asthma treatment aims to keep your symptoms under control and prevent asthma attacks or sudden worsening of symptoms, so that your asthma does not interfere with your daily activities and you can enjoy a full and active life.
There are many different types of asthma medicines and sometimes you will have to take more than one. These are usually puffers or inhalers but may also be tablets.
If you have mild asthma, you can use budesonide/formoterol as a reliever, without needing to use it regularly as a preventer as well. This is called AIR therapy (anti-inflammatory reliever therapy).
If you have moderate to severe asthma, you can use budesonide/formoterol as both a preventer and and also as a reliever. This is called SMART (which stands for single maintenance and reliever therapy). This means that you can use your inhaler regularly each day for symptom prevention, and also when needed for symptom relief.
Salbutamol or terbutaline
These are used for relief of asthma symptoms when you are using a steroid inhaler for prevention.
Tell your doctor if you need to use it more than twice a week - this could mean that your asthma is probably not controlled.
People with asthma are at increased risk of complications from the flu, even if their symptoms are mild or well-controlled by medication. Complications include pneumonia (lung infection), heart failure and worsening asthma symptoms. The flu is also associated with increased risk of hospitalization for people with asthma.
Ask your doctor about getting the flu vaccination to reduce your risk of flu.
The flu vaccine is usually free for people with asthma, if they are on regular preventative therapy.
It is best to get vaccinated before the start of the winter season, before influenza enters the community.
It’s important to get the flu jab every year because each year the flu vaccine is developed to match the different strains of flu virus you are likely to encounter.
Keep an eye on your symptoms. If you are getting wheezy more than two times a week, it may mean your asthma is not well controlled. See your doctor for a check-up.
If you have symptoms of hay fever (allergic rhinitis), such as nasal congestion, runny nose, sneezing, itchy eyes, talk to your doctor about medication to treat these symptoms, such as antihistamines or nasal steroid sprays. Treating hay fever can improve your asthma symptoms.
What self-care can I do with asthma?
There are many things you can do to improve how well your asthma is controlled. By working with your doctor or nurse to create an asthma action plan, you can reduce how bad your asthma symptoms are and how often you have them.
Understand your asthma and learn to recognise your symptoms and your triggers.
Take your prescribed medication – especially your preventer – every day, regardless of whether you have asthma symptoms or not.
If you smoke, try to quit. Try to keep clear of anyone else who smokes and of any other fumes.
Ask your doctor about managing allergies if these are a known trigger for you.
Use a peak flow meter to take and record regular readings to check that your asthma is under control.
Keep active – physical activity improves how well your lungs work, and people who are fit usually find they have less asthma and cope better when they do have it.
Visit your asthma team (your GP, your practice nurse and your pharmacist) regularly. They will review the medications you are taking and can teach you how to use your inhaler properly so you get the most benefit.
Asthma New Zealand provides education, training and support to individuals with asthma/COPD and their families. Read more.
Is there an app for that?
There are variety of mobile apps available for people with asthma. These can be a useful way to learn about and take control of your asthma, eg, they can help you keep track of your symptoms, triggers, peak flow readings and medication. You can also create an asthma action plan together with your doctor or nurse. The Health Navigator app library team has reviewed some asthma apps that you may like to consider. Read more about asthma apps.
Joanna Turner is the Research & Education Manager for the Asthma & Respiratory Foundation NZ. She is responsible for overseeing and managing the development and implementation of key education programmes. She sits on the ARFNZ Scientific Advisory Board and assists in the development and dissemination of the NZ Child Asthma Guidelines, the NZ Adolescent and Adult Asthma Guidelines and the NZ COPD Guidelines.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Sandra Hotu, Respiratory Physician, ADHB and Joanna Turner, Research & Education Manager, Asthma & Respiratory Foundation NZ
Last reviewed: 27 Aug 2020
What is an asthma action plan?
It can be hard to remember directions or instructions from your healthcare provider. That's why you also need an asthma action plan. This is a written document to help you remember what you need to do to manage your asthma well.
It includes information on how to:
manage your asthma daily, including taking medications correctly
identify and avoid exposure to allergens and irritants that can bring about asthma symptoms
recognise and handle worsening asthma symptoms, and when, how, and who to contact in an emergency.
You can develop your asthma management plan with your healthcare provider. It will be based on how severe your asthma is and your preferences. At each visit with your healthcare provider, you can review your plan and make changes as needed.
What are the benefits of an asthma action plan?
Using an asthma action plan that meets your individual needs has been found to:
reduce absences from work or school
reduce hospital admissions
reduce emergency visits to general practice
reduce reliever medication use
improve lung function.
Sample asthma action plans
Note: Some of these resources are from other countries so make sure you know the emergency numbers for New Zealand. Ring 111 for emergencies or Healthline 0800 611 116.
These resources are for adults with asthma. See asthma in children for information and resources for children with asthma.
Resources for adults
Topics (some available in other languages)
Asthma Action Plan Asthma & Respiratory Foundation NZ (to be worked through with your healthcare provider)
Cheyanne’s story: Mum’s first time experience with life-threatening asthma
Cheyanne tells her story of the near-death experience by asthma of her daughter Ngamihi.
Cheyanne McConnell from Hamilton has two beautiful daughters. Her oldest is Ngamihi Lyndon, who has asthma, and Anahera Lyndon is the younger of the two. Cheyanne is deaf, therefore uses sign language, and Ngamihi helps her as a sign language interpreter. Cheyanne describes Ngamihi as really lovely and very amazing for doing this. She says both her daughters are really sweet girls.
Unfortunately, in early 2015, Cheyanne and her family had a frightening experience with asthma. Ngamihi was in a serious condition and needed to be taken to the hospital. Cheyanne explains, “It was very hard for my daughter Ngamihi, she nearly died. I took her straight to the hospital. I’m very lucky. I feel shocked that Ngamihi had asthma.”
The whole experience was incredibly emotional and traumatising. “Ngamihi in hospital made us all cry, she nearly died. She had fallen down, she was wheezing and upset crying. She had a hard cough and dry throat," says Cheyanne. This was Cheyanne’s first time in dealing with asthma, as she had never experienced it before and didn’t know anything about the condition.
To learn more about asthma, Cheyanne got in contact with Asthma Waikato to book an appointment for one-on-one asthma education. Cheyanne says, "I need to learn more about asthma for my daughter Ngamihi. It's very important".
Cheyanne recently completed her training with a very positive experience. She says about her asthma educator, Victoria Johnstone, "She's very great. I like to learn about asthma, it helps me understand. The training worked out all good." This education will help her look after and manage Ngamihi’s asthma.
Asthma societies such as Asthma Waikato offer friendly, specialised support, information and resources to assist people manage their respiratory condition. If you'd like to get in touch with an asthma society in your region, view the list here."
Alistair's story: Ironman & asthmatic
Alistair is a chronic asthmatic, but he’s also an Ironman. He’s had a few health challenges but he’s learned ways to manage his condition so he can compete at a high level in a triathlons.
"My childhood was punctuated with time in and out of hospital, although my parents were proactive in sourcing the best treatments available, including my very own nebuliser," he says.
"My asthma is at the worst end of the scale: it’s severe, especially if I don’t do my best to control it. Many things cause my asthma and even when it’s managed well, there are certain triggers that all the control in the world won’t stop an attack from coming on.
In late 1999 I was introduced to triathlons. It was not long before I was hooked and in 2005 I made the NZ Age Group Team for the Triathlon. In 2006 I took time out from sport. By 2009 I was struggling to do anything in the way of activity that lasted longer than 20 to 30 minutes, without the need for my reliever inhaler.
After having a lot of time off (three to four years) I was 25 kg heavier and much older. I realised then my triathlon training had helped me take control of my asthma in a way no other sport had ever done. I knew I had to get back into it, which meant I had to build up my training slowly and steadily.
Given how severe my asthma is, it’s crucial I manage myself well. Additionally, the sport I do has me actively engaging with asthma triggers on a daily basis. The key stages to my successful management have been:
Regular visits to my health practitioner (I used to go every six months but now I am down to yearly, which is an excellent sign that I am more in control of my asthma).
Undertaking tests to confirm what triggers my asthma. Some I class as core triggers (they trigger me no matter what), and the rest I class as secondary triggers (these can be managed by lifestyle and adaption).
Getting onto the right medication for my asthma.
Ensuring I am taking my preventative as prescribed.
Constantly monitoring to understand what I feel like when I require my blue inhaler, and observing what is going on with me and the environment when this occurs.
Successful management of asthma has been a lifestyle choice. I know it works, because when I choose to alter my lifestyle I see and feel the difference in my asthma. I am proof that no matter how severe your asthma condition is, there is a way to take back control of your asthma and your life."
Alistair 'Ironman for Asthma' generously fundraises for The Asthma & Respiratory Foundation NZ, as well as raising awareness of asthma in the community. For more information on Alistair and how to support him, visit his Ironman for Asthma Facebook page or his TriCharity page.
To help manage your or a family member's asthma, it's important to have an asthma plan in place. See your doctor and ask for an asthma plan.
Medicated asthma prevalence showed no significant change during the study period in adults or children. The hospitalisation rate for asthma peaked in 2009 at 218 per 100,000 people, and overall declined slightly over the study period. Asthma mortality rates, however, which appeared to be declining in the previous report, have returned to previous higher levels, peaking at 2.0 deaths per 100,000 in 2014.
Risks for asthma were similar across measures. Prevalence, hospitalisation and mortality were all significantly higher for both Māori and Pacific peoples, and in more socioeconomically deprived neighbourhoods. In children, all asthma measures were higher for boys, whereas for adults, asthma measured higher for women.
Socio-economic differences in asthma hospitalisation saw rates 2.7 times higher in the most deprived NZDep2013 quintile 9-10, and 1.9 times higher in NZDep2013 quintile 7-8, compared to the wealthiest NZDep2013 quintile. These differences were similar to mortality differences. Asthma prevalence showed a deprivation gradient for female children, but not for female adults, and not for males.
2017 asthma hospitalisation rates were lower than the national average in all South Island DHBs except West Coast, and higher than the national average in all North Island DHBs except Auckland, Waitematā, MidCentral and Capital and Coast; 2015 mortality rates were highest in the Tairawhiti and LakesDHBs.
In this webinar, Dr Andrew Corin shares pragmatic approaches to asthma management in an appropriate and patient-personalised way. He will discuss the value of real-world effectiveness data, and how this guides treatment selection for optimised patient outcomes.
(Goodfellow Unit Webinar, NZ, 2020)
Asthma & Respiratory Foundation NZ adult asthma guidelines - A quick reference guide by Professor Richard Beasley
Asthma & COPD Fundamentals Course Asthma & Respiratory Foundation NZ This course aligns the latest research with specific information for the New Zealand context, such as recently funded medications, treating Māori and Pasifika peoples, and best practice health literacy.
The course aligns with the latest New Zealand asthma guidelines. It includes two half day workshops covering the key aspects of COPD and asthma pathophysiology, management and practice.