Is your asthma well controlled? What the GINA 2026 guidelines say

The 4 questions behind symptom control (GINA 2026)

GINA assesses your symptom control by asking 4 questions about the past 4 weeks:

• Daytime asthma symptoms more than twice a week?
• Any night awakenings due to asthma?
• Need for your reliever inhaler more than twice a week?
• Any activity limitation because of asthma (sport, work, daily life)?

Three levels of symptom control

Count how many of the 4 questions above you'd answer "yes" to, over the past 4 weeks:

• Well controlled: none of the 4
• Partly controlled: 1 or 2 of the 4
• Uncontrolled: 3 or 4 of the 4

Well controlled doesn't mean zero risk

Symptom control tells you how your asthma has felt recently — it doesn't fully capture your risk of a future flare-up. GINA treats these as two related but different things. Some people have very few day-to-day symptoms and can still be more exposed to a severe attack because of other factors, such as:

• Having had a severe asthma attack in the past year
• Needing your reliever inhaler often, even without daily symptoms
• Smoking, exposure to smoke, or other health conditions affecting your breathing

👉 Feeling fine today is genuinely good news — it just doesn't automatically mean your risk of a flare-up is zero.

Why your reliever treatment matters too

Asthma guidelines, including the 2026 GINA update, have moved away from "just take a bronchodilator when you're short of breath." A reliever used alone, without any anti-inflammatory treatment, is no longer the recommended approach.

• The reliever now recommended in most cases combines a fast-acting bronchodilator with a low-dose inhaled corticosteroid
• This combination has been shown to lower the risk of severe attacks compared with a bronchodilator-only reliever

This doesn't mean changing your treatment on your own — the right reliever and maintenance plan for you should always be decided with your doctor.

Why take part?

• Compare your experience with other asthma patients
• Help raise awareness of real asthma experiences
• Contribute to improving asthma tracking tools