Written by Carol Stonham MBE
This article reflects the opinions of a healthcare professional. The views expressed are their own. The intended use for the NObreath® is as follows:
The 2nd generation NObreath® is a breath nitric oxide (NO) test system intended to measure fractional exhaled nitric oxide (FeNO) in parts per billion (ppb) in exhaled breath.
The measurement is taken to evaluate airway inflammation and should be used in conjunction with other clinical and laboratory evaluations where appropriate when making a diagnosis or treatment plan. The measurements are intended for interpretation by healthcare professionals and for us in a healthcare environment, where paediatric and adult patients will complete measurements under supervision.
For many people lungs don’t really feature in their daily self-awareness despite the vital work they do. They are there in the background doing their job. For many people Love your Lungs week might just make them think about what a good job their lungs are doing and maybe look for ways of encouraging them to stay healthy – avoiding pollution, not smoking or vaping and getting regular exercise in for example.
Love Your Lungs Week and Asthma
For those people with asthma Love Your Lungs week might have a different emphasis. Asthma symptoms, whether minor or more dramatic, will certainly make a person aware of their breathing. Good asthma care can help to keep the symptoms under control and avoid bouts of acute symptoms.
Good asthma care starts with an accurate diagnosis. Historically an asthma diagnosis was made on assessment of symptoms, perhaps some lung function testing, and response to treatment. Evidence shows us we sometimes got it wrong using this approach 1. The current joint UK guidelines from British Thoracic Society (BTS), Scottish Intercollegiate Network (SIGN) and National Institute for Health and Care Excellence (NICE)2 have moved to basing a diagnosis of asthma on assessment of symptoms and history that is supported by objective testing. Fractional exhaled nitric oxide (FeNO) is the first recommended test based on clinical accuracy and cost effectiveness. A raised FeNO is an indicator of eosinophilic airway inflammation which is commonly seen in most types of asthma when it is not adequately treated with inhaled corticosteroids (ICS).
Once an accurate diagnosis has been made the person being diagnosed needs to understand what asthma is, what is happening in their lungs, and how their treatment works. There is no agreed education sessions for people newly diagnosed with asthma as there are for those with diabetes.
As asthma is a variable condition, understanding these features support the person to adjust medication to control symptoms and self-manage their condition. Healthcare input is minimal in someone with asthma – an annual review is usually the only planned touch point; others tend to be when the symptoms are poorly controlled. Most healthcare professionals will use a diagram or airway model to explain asthma but the addition of FeNO is a useful tool to demonstrate inflammation especially in the symptomatic person. It helps both practitioner and patient to understand what is happening in the lungs – a measured objective marker demonstrating inflammation.
Why Objective Assessment Remains Important
Many people with a long-term health condition will become so used to the symptoms they experience and the regular use of treatment4. This is seen in some people with asthma – they accept that they have asthma therefore they accept a wheeze or cough4, they stop taking regular ICS treatment and instead rely on a rescue inhaler to treat symptoms as they arise4, or they might continue treatment but fall into bad habits and use their inhaler incorrectly5. In all of these cases measuring FeNO is helpful to assess the underlying airway inflammation, to demonstrate suboptimal control of airway inflammation, and to base ongoing treatment decisions which may require a change of medication, a change of inhaler device or commonly, simply a reminder that asthma treatment needs to be taken regularly with good technique.
The NObreath® FeNO Device
FeNO testing with the NObreath® is a quick and easy non-invasive way to objectively measure airway inflammation. With adult and child test modes, the NObreath® is suitable for all settings thanks to its accuracy and portability. Featuring an exhalation-only manoeuvre, the test is easy to do and can help to improve asthma care, allowing healthcare professionals to tailor asthma treatment effectively.
Love Your Lungs for those with asthma should focus on getting the treatment right and taking it effectively and regularly so that the lungs can get on doing their job without reminding the person they have asthma at all. Of course, that will also include the general measures that everyone else will be considering – avoiding pollution, avoiding smoking and vaping, and getting regular exercise in, but good asthma care will support activity without a symptom burden.
References:
- Aaron SD, Vandemheen KL, FitzGerald JM, Ainslie M, Gupta S, Lemière C, Field SK, McIvor RA, Hernandez P, Mayers I, Mulpuru S. Reevaluation of diagnosis in adults with physician-diagnosed asthma. JAMA. 2017;317(3):269-79.
- National Institute for Health and Care Excellence. Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) (NG245) [Internet]. London: NICE; 2024 [cited 2026 18 Jun]. Available from: https://www.nice.org.uk/guidance/ng245
- Patel S, Huang M, Miliara S. Understanding treatment adherence in chronic diseases: challenges, consequences, and strategies for improvement. Journal of Clinical Medicine. 2025 Aug;14(17):6034. DOI: 10.3390/jcm14176034.
- Canonica GW, Domingo C, Lavoie KL, Kaliasethi A, Khan SQ, Majumdar A, Fulmali S. Asthma patients’ and physicians’ perspectives on the burden and management of asthma: post-hoc analysis of APPaRENT 1 and 2 to assess predictors of treatment adherence. Respiratory medicine. 2024;227:107637.
- Bosnic-Anticevich S, Bender BG, Shuler MT, Hess M, Kocks JW. Recognizing and tackling inhaler technique decay in asthma and chronic obstructive pulmonary disesase (COPD) clinical practice. The Journal of Allergy and Clinical Immunology: In Practice. 2023;11(8):2355-64.
