Smoking literacy amongst adult Asian asthma patients in primary care

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.